A 70-year-old woman with Type 2 diabetes has lab results that show a serum creatinine of 2.1 mg/dL and an eGFR of 40 mL/min. What could be causing these results and how should it be managed?
These laboratory results suggest chronic kidney disease (CKD), possibly due to diabetic nephropathy given her history of Type 2 diabetes. Other causes of CKD should also be considered. Management includes tight control of blood glucose and blood pressure (with an ACE inhibitor or ARB if not contraindicated) to slow the progression of kidney disease. Dietary modifications may be necessary. Referral to a nephrologist should be considered.