Description
The webinar on “New Pillars in the Management of Diabetic CKD” will focus on the evolving strategies for managing chronic kidney disease in patients with diabetes. It will discuss recent advancements in pharmacologic therapies such as SGLT2 inhibitors, GLP-1 receptor agonists, and non-steroidal MRAs, which have transformed treatment outcomes. Experts will highlight the importance of early detection, comprehensive risk assessment, and multidisciplinary care in slowing disease progression. The session aims to provide clinicians with updated evidence-based approaches to improve renal and cardiovascular outcomes in diabetic CKD patients.
Summary Listen
- Chronic Kidney Disease (CKD) is a global health crisis, affecting an estimated 850 million people worldwide, with a high prevalence, significant morbidities, increased mortality rates, and placing a considerable burden on healthcare resources. The World Health Organization (WHO) anticipates CKD will become a leading cause of death in the coming years, emphasizing the need for preventive measures.
- Diabetes is a major contributor to CKD, accounting for approximately 40% of cases. The global prevalence of diabetes is rapidly increasing, with projections indicating nearly 800 million people will have diabetes by 2040. Local data from Abu Dhabi reveal a high prevalence of reduced kidney function and CKD, highlighting the need for targeted early detection and intervention strategies.
- Cardiovascular disease, kidney disease, and diabetes are interconnected and amplify each other, leading to increased morbidity and mortality. The American Heart Association recognizes the link, defining cardio-kidney-metabolic (CKM) syndrome, emphasizing the need for a holistic approach to address these conditions. These conditions also present significant economic burdens, accounting for a substantial portion of healthcare spending.
- Early detection of CKD is crucial through annual screening of at-risk individuals, particularly those with diabetes or hypertension. The urine albumin-to-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) are essential screening tools. Risk stratification, using a heat map based on eGFR and proteinuria, helps guide management strategies.
- Since 2012, treatment for CKD has expanded beyond traditional ACE inhibitors and ARBs to include SGLT2 inhibitors, non-steroidal MRAs (mineralocorticoid receptor antagonists), and GLP-1 receptor agonists. These new medications, studied in multiple randomized controlled trials, offer cardio-renal protection and have led to updated guidelines promoting a holistic approach to CKD management.
- SGLT2 inhibitors work by increasing glucose and sodium excretion, leading to afferent vasoconstriction and decreasing intraglomerular pressure. Non-steroidal MRAs, like finerenone, target inflammation and fibrosis, key drivers of CKD progression. GLP-1 receptor agonists improve glycemic control, reduce blood pressure, and exert direct effects on the kidneys.
- Future treatment pillars may include endothelin receptor antagonists and aldosterone synthase inhibitors. Novel potassium binders, such as patiromer and sodium zirconium cyclosilicate, enable the use of RAAS inhibitors and MRAs without the concern for hyperkalemia. Lifestyle modifications, including diet, exercise, and smoking cessation, are also crucial components of comprehensive CKD care.
- Effective implementation of CKD therapeutic strategies requires risk assessment, early diagnosis, risk stratification, and access to monitoring. A multidisciplinary team approach, involving primary care physicians, cardiologists, nephrologists, and endocrinologists, is essential. Early intervention with pillar therapies can significantly delay the need for renal replacement therapy and improve patient outcomes.
Sample Certificate
About the Speakers
Dr. Emad Khater
Nephrology Consultant, Seha Kidney Care & Shaikh Khalif Medical City, Clinical Assistant Professor in the College of Medicine and Health Science, UAE University, UAE
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