A 63-year-old man with type 2 diabetes and albuminuric chronic kidney disease has HbA1c 60 mmol/mol, eGFR 48 mL/min/1.73 m2, and urine

Question

A 63-year-old man with type 2 diabetes and albuminuric chronic kidney disease has HbA1c 60 mmol/mol, eGFR 48 mL/min/1.73 m2, and urine albumin-creatinine ratio 42 mg/mmol. He takes metformin and an ACE inhibitor, and has no history of ketoacidosis. What is the most appropriate screening/prevention?

Accepted Answer

Add an SGLT2 inhibitor for kidney and cardiovascular protection

Answer

Avoid any further therapy until eGFR is below 30

Answer

Stop ACE inhibitor because albuminuria persists

Answer

Add glyburide as the preferred kidney-protective agent

Answer

Start chronic systemic corticosteroids

Diabetic kidney disease — MCCQE Part 1 MCQ

A 63-year-old man with type 2 diabetes and albuminuric chronic kidney disease has HbA1c 60 mmol/mol, eGFR 48 mL/min/1.73 m2, and urine albumin-creatinine ratio 42 mg/mmol. He takes metformin and an ACE inhibitor, and has no history of ketoacidosis. What is the most appropriate screening/prevention?