A 60-year-old man came to your office complaining of edema in his face and lower limb, he has no chest pain no breathlessness, he had DM for 15 years on exercise, diet and oral medications, last moth his HbA1c was 6.9%, his BP is 146/87 and RR 15, HR and other vitals are normal. On examination he has periorbital Edema and bilateral LL pitting edema, other Physical examinations were unremarkable. Labs: Na 140 (135-145), K 4.5 (3.5-5) and Glucose 120 (N <200) BUN 37, Cr 2.3, Urine protein 3,600mg. Normal ECG. Which of the following measures have great impact on slowing his kidney progression?
سؤال مجاني 8 من 10 اليوم · اشترك وكمّل بدون حد
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الإجابة: C. Intensive BP control
This is diabetic nephropathy with nephrotic-range proteinuria and BP above target (146/87). Tight BP control (target < 130/80 in diabetes/albuminuria), ideally with an ACE inhibitor/ARB to reduce proteinuria, is the measure that most slows CKD progression, whatever the cause.
- Glycemic control is already good (HbA1c 6.9%) and mainly prevents worsening proteinuria.
- Lipid control and aspirin reduce cardiovascular events, not the rate of renal decline.
- المصدر
- CKD +RRT.pdf · p. 3
Step Up To Medicine 6th, 2024 (CKD).pdf · p. 5 - المحاضرة
- AKI & CKD · Nephrology · Module C
- ظهر في
- MED42 ♂ EOM C