Question

A 58-year-old with T2DM, eGFR 38 mL/min/1.73 m², and ACR 350 mg/g is on maximally tolerated ACE inhibitor. Next best step to slow CKD progression and reduce CV risk?

Accepted Answer

Start SGLT2 inhibitor (e.g., empagliflozin)

Answer

Add non-DHP calcium channel blocker

Answer

Switch ACE inhibitor to ARB due to albuminuria

Answer

Start finerenone without SGLT2 inhibitor

Answer

No additional therapy indicated

Practice question

A 58-year-old with T2DM, eGFR 38 mL/min/1.73 m², and ACR 350 mg/g is on maximally tolerated ACE inhibitor. Next best step to slow CKD progression and reduce CV risk?