skip to main content

Diabetic CKD with Albuminuria — ESENeph MCQ

Instant feedback + full explanation. One question, done properly.

HardNephrologyDiabetic CKD with AlbuminuriaESENeph

A 62-year-old with CKD G3b (eGFR 32 mL/min/1.73 m²) and albuminuria A3 (UACR 400 mg/g) with diabetes is on maximally tolerated ACE inhibitor and an SGLT2 inhibitor. BP controlled, K⁺ 4.6 mEq/L. Next disease-modifying addition?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Add nonsteroidal MRA (finerenone)

In diabetic CKD with persistent albuminuria despite ACEi/ARB and SGLT2 inhibition, adding a nonsteroidal MRA (finerenone) reduces kidney and CV events. Stopping ACEi (A) is harmful. Thiazide (B) or CCB (C) manage BP only. Loop diuretic (E) is for volume control, not disease modification.

Reference: Secondary Source: KDIGO (2024): Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease