A known case of chronic kidney disease stage 4 is on insulin therapy. What adjustment in insulin dosage is required?
Increase dose of insulin
Decrease dose of insulin
Variable
No alteration in dose
Some of the insulin is cleared by the kidneys. No dose adjustment is required if GFR is more than 50 mL/min. If GFR is less than 50 mL/min, then insulin dose should be reduced. As in CKD stage 4 GFR is <15mL/min so the dose of insulin should be decreased.
Pancreas