Afghanistan Comprehensive Specialization Exam

Practice session

A 62-year-old male with long-standing Type 2 Diabetes Mellitus, ischemic cardiomyopathy (HFrEF, LVEF 32%), and Stage 3b Chronic Kidney Disease with persistent albuminuria (eGFR 38 mL/min/1.73 m2, urine albumin-to-creatinine ratio [UACR] 450 mg/g) is evaluated in the multidisciplinary Cardiorenal-Metabolic clinic. He is currently taking maximally tolerated empagliflozin, carvedilol, sacubitril/valsartan, and a statin. His serum potassium is 4.3 mEq/L and HbA1c is 7.4%. Based on landmark cardiorenal clinical trials (FIDELIO-DKD and FIGARO-DKD), which novel disease-modifying agent is recommended to provide dual renal and cardiovascular risk reduction?

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