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Updates on Clinical Use of Non-Steroidal Mineralocorticoid Receptor Antagonists in the Management of Chronic Kidney Disease in Patients With Type 2 Diabetes

  1. SGLT2 inhibitors were initially approved by the FDA for the treatment of hyperglycemia in patients with type 2 diabetes based on efficacy data from large, randomized outcomes trials.
    How can the most common adverse event with SGLT2 inhibitors be managed?
    Drink cranberry juice
    Take prophylactic antibiotics
    Use topical antifungal medications
  2. Dedicated renal outcomes trials of SGLT2 inhibitors in patients with CKD with or without diabetes has shown what consistent result?
    No effect on heart failure
    Slowing of age-related decline in GFR
    SGLT2 inhibitors should not be used below eGFR of 45 mg/min/1.73m2
  3. Finerenone, the only FDA-approved nonsteroidal MRA for CKD in type 2 diabetes, showed what effect on CV events in clinical trials?
    Increased CV events
    No effect on CV events
    Reduced CV events
  4. While the risk of hyperkalemia is less with nonsteroidal MRAs than with steroidal MRAs, serum potassium still needs to be measured and monitored.
    The dose of finerenone should be withheld when serum potassium reaches what level?
    Greater than 4.8 mmol/L
    Greater than 5.5 mmol/L
    Greater than 6.5 mmol/L