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🌱 Beginner Level — 0 / 60

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Diabetic Nephropathy (DKD) — Albuminuria With Progressive eGFR Decline

A 58-year-old with 15-year T2DM has UACR 480 mg/g and eGFR 55→42 mL/min/1.73 m² over 18 months. BP 146/86 on amlodipine. A1c 8.1%. Fundus: diabetic retinopathy.

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💡 Hint: Correct order adjusted to match available steps.

Start/titrate ACEi/ARB to max tolerated dose

Add GLP-1 RA if glycemia/weight suboptimal

Consider finerenone for persistent albuminuria

Add SGLT2 inhibitor (eGFR-permitting)

Target BP <130/80 with RAAS backbone + add-on

Avoid NSAIDs and contrast when possible

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