Peritoneal dialysis leak — ESENeph MCQ
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Correct answer: C — Finerenone after confirming potassium monitoring and NHS eligibility
The best answer is “Finerenone after confirming potassium monitoring and NHS eligibility”. NICE recommends finerenone for defined adults with CKD associated with type 2 diabetes when optimized standard care is insufficient; serum potassium and kidney function determine safe initiation and follow-up. “A second ACE inhibitor to intensify RAS blockade” is less appropriate because duplicate RAS therapy adds harm “High-dose spironolactone without potassium surveillance” is less appropriate because hyperkalaemia risk requires careful selection and monitoring “Dietary sodium loading to improve kidney perfusion” is less appropriate because this worsens blood pressure and albuminuria “Stopping all kidney-protective therapy because albuminuria persists” is less appropriate because residual risk prompts layered treatment rather than abandonment
Reference: NICE TA877: finerenone for treating CKD in type 2 diabetes: https://www.nice.org.uk/guidance/ta877/chapter/1-Recommendations