What is the dose adjustment required for insulin in a patient who is diagnosed as stage IV CKD
During the later phase of declining renal function, insulin requirements may fall as kidney is a site of insulin degradation. some glucose lowering agents(sulphonylureas and metformin) are contraindicated in advanced renal insufficiency Ref:Harrison 20th edition pg no 2878
Increased insulin
Decreased insulin
No change
Add DPP-4 inhibitor
Kidney