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Clinical implications and guidelines for CKD in type 2 diabetes
Rong M Zhang1, Frederik Persson2, Janet B McGill1
1Division of Endocrinology, Metabolism and Lipid Research, Washington University School of Medicine, St Louis, MO, USA.
Summary
New guidelines for managing type 2 diabetes (T2D) and chronic kidney disease (CKD) include SGLT2 inhibitors and finerenone. These therapies, alongside blood pressure and glucose control, aim to improve kidney outcomes and reduce mortality in T2D patients.
Area of Science:
- Nephrology
- Endocrinology
- Clinical Medicine
Background:
- Chronic kidney disease (CKD) is a significant complication of type 2 diabetes (T2D), contributing to high morbidity and mortality rates.
- The increasing prevalence of T2D globally is driving a rise in CKD cases.
- Clinical trials have investigated novel therapies to slow CKD progression, reduce cardiovascular events, and decrease mortality in T2D patients.
Purpose of the Study:
- To review current guidelines for managing CKD in T2D.
- To incorporate findings from recent clinical trials on renal outcomes.
- To provide evidence-based recommendations for clinical practice.
Main Methods:
- Review of epidemiological data for CKD in T2D.
- Analysis of the guideline development process, including data gathering and consensus.
- Evaluation of recent clinical trial results for renal and cardiovascular outcomes.
Main Results:
- All guidelines recommend annual CKD screening, blood pressure, and glucose control.
- Renin-angiotensin system (RAS) inhibition is a consistent first-line therapy.
- Sodium-glucose cotransporter-2 (SGLT2) inhibitors and finerenone are now recommended for improved CKD outcomes in T2D.
Conclusions:
- Current guidelines emphasize CKD screening, RAS inhibition, and glucose control for T2D management.
- SGLT2 inhibitors and finerenone represent significant advancements in managing CKD in T2D, supported by robust clinical data.
- These updated recommendations aim to improve renal and cardiovascular outcomes in individuals with T2D and CKD.
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