A 61-year-old woman with type 2 diabetes has CKD despite maximally tolerated losartan. eGFR is 38 mL/min/1.73 m², urine ACR is 78 mg/mmol and

Question

A 61-year-old woman with type 2 diabetes has CKD despite maximally tolerated losartan. eGFR is 38 mL/min/1.73 m², urine ACR is 78 mg/mmol and potassium is 4.8 mmol/L. HbA1c is 58 mmol/mol and there is no history of recurrent genital infection. What is the most appropriate management?

Accepted Answer

Add an SGLT2 inhibitor with sick-day advice

Answer

Stop losartan before adding any renal-protective drug

Answer

Start long-term oral steroid therapy

Answer

Begin erythropoietin because ACR is elevated

Answer

Refer for pre-emptive transplantation immediately

Diabetic CKD — ESENeph MCQ

A 61-year-old woman with type 2 diabetes has CKD despite maximally tolerated losartan. eGFR is 38 mL/min/1.73 m², urine ACR is 78 mg/mmol and potassium is 4.8 mmol/L. HbA1c is 58 mmol/mol and there is no history of recurrent genital infection. What is the most appropriate management?