A 72-year-old man attended for his annual diabetes review. He has a history of type II diabetes
A 72-year-old man attended for his annual diabetes review. He has a history of type II diabetes for which he takes Gliclazide 80mg BD, hypertension for which he takes Bendroflumethiazide 2.5mg OD and osteoarthritis for which he takes Ibuprofen 600mg TDS. His blood pressure was 158/93 mmHg and grade II hypertensive retinopathy was seen on fundoscopy. Investigations were as follows:
| HbA1c | 66 mmol/mol (20-42) |
| serum urea | 10.9 mmol/L (2.5-7.0) |
| serum creatinine | 115 mol/L (60-110) |
| eGFR | 59 ml/min (>60) |
| Urinalysis | protein + |
Which of the following is the likely cause of these findings?
Select the SINGLE most appropriate option from the list below. Select ONE option only.
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