Diabetic CKD — ESENeph MCQ

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HardNephrologyDiabetic CKDESENeph

A 63-year-old with CKD G3b and albuminuria (UACR 350 mg/g) has T2DM on ACEI and SGLT2i. Next renoprotective addition?

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Correct answer: D — Add finerenone

KDIGO supports SGLT2i plus maximally tolerated RAAS blockade; in diabetic CKD with albuminuria, adding nonsteroidal MRA (finerenone) reduces progression and CV events. RAAS inhibition should be continued/titrated if tolerated. A loop diuretic is not renoprotective. Additional benefit with finerenone exists.

Reference: KDIGO Guideline (2024): CKD Evaluation and Management