A 61-year-old man with type 2 diabetes comes for follow-up. A1c is 7.3%, eGFR is 58 mL/min/1.73 m2, and urine albumin-creatinine ratio is 220 mg/g.

Question

A 61-year-old man with type 2 diabetes comes for follow-up. A1c is 7.3%, eGFR is 58 mL/min/1.73 m2, and urine albumin-creatinine ratio is 220 mg/g. Blood pressure is 128/76 mm Hg on lisinopril. He has no edema. Which of the following would you recommend at the follow-up visit?

Accepted Answer

Add an SGLT2 inhibitor

Answer

Begin daily NSAID therapy

Answer

Add hydrochlorothiazide for albuminuria

Answer

Refer for dialysis access planning

Answer

Stop lisinopril because creatinine is reduced

Chronic kidney disease in diabetes — USMLE Step 3 MCQ

A 61-year-old man with type 2 diabetes comes for follow-up. A1c is 7.3%, eGFR is 58 mL/min/1.73 m2, and urine albumin-creatinine ratio is 220 mg/g. Blood pressure is 128/76 mm Hg on lisinopril. He has no edema. Which of the following would you recommend at the follow-up visit?