Which of the statements are TRUE regarding management of Chronic Kidney Disease?

I. Maintaining protein intake of 0.8 g/kg/day for those with diabetes and non-dialysis CKD.

II. Reducing sodium intake to 1,500 mg of sodium per day in patients with diabetes and CKD.

III. Target HbA1c should be ≤7% in diabetic kidney disease but this should be individualised according to co-morbidities and age.

IV. CKD is defined as eGFR <60 ml/min/1.73 m2 that is present >3 months with/without evidence of kidney damage.

Which of the following medications should be avoided in patient with eGFR <30 ml/min?

I. Metformin

II. Gliclazide

III. Vildagliptin

IV. Linagliptin

What is correct dose recommended for patient with eGFR <30 mL/min?

I. Tab Empaglifozin 10 mg BD

II. Tab Danaglifozin 10 mg BD

III. Tab Linagliptin 2.5 mg OD

IV. Tab Metformin 500 mg BD

What is the starting dose recommended for patient with eGFR 60 mL/min?

I. Tab Vildagliptin 50 mg BD

II. Tab Gliclazide 80 mg BD

III. Tab Metformin 500 mg BD

IV. Tab Canaglifozin 100 mg BD

Which of the following statement(s) is/are FALSE?

I. HbA1c target should be <6.5% for all patients with diabetes kidney disease (DKD) regardless of the co-morbidities.

II. All DPP-4 inhibitors require dosage adjustment in CKD.

III. Vildagliptin and Empaglifozin can be given together if glycaemic control is still not achieved.

IV. There is increased risk of forefoot amputation in patients given Canaglifozin.

The side effects of Metformin include the following EXCEPT:

I. Vitamin B12 deficiency

II. Weight gain

III. Diarrhea

IV. Lactic acidosis

Which of the following clinical trials exploring medicines for Diabetes in Chronic Kidney Disease?

I. ACCORD trial

II. FIDELIO-DKD trial

III. CREDENCE trial

IV. CANVAS-R trial

Which of the statement(s) about Empaglifozin is/are TRUE?

I. Once an SGLT2-i is initiated, it is reasonable to continue an SGLT2i even if eGFR falls < 30 ml/min.

II. Empaglifozin provides similar renal protection effect regardless of the dose given.

III. Empaglifozin may increase proteinuria in DKD.

IV. There is no need for dosage adjustment for Empaglifozin when eGFR falls < 60 ml/min.

Which of the following statement(s) is/are FALSE?

I. Empaglifozin and Metformin can be given together.

II. DPP-4 inhibitors lower blood glucose with low risk of hypoglycemia but have not been shown to improve kidney or cardiovascular outcomes.

III. DPP-4 inhibitors should not be used in combination with GLP-1 RA.

IV. Metformin is eliminated via kidney and may accumulate in body as kidney function deteriorates.