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Mitigating heart failure risk in patients with diabetes and chronic kidney disease

Nicholas S Kowalczyk1, Megan Prochaska

  • 1Department of Medicine, University of Chicago, Chicago, Illinois, USA.

Current Opinion in Cardiology
|February 25, 2025
PubMed

Insights

Nonsteroidal mineralocorticoid receptor antagonists (ns-MRA) and glucagon-like peptide 1 receptor agonists (GLP-1 RA) significantly benefit patients with chronic kidney disease and diabetes. These medications should be integrated into comprehensive cardiovascular risk reduction strategies for this high-risk population.

Area of Science:

  • Cardiology
  • Nephrology
  • Endocrinology

Background:

  • Patients with chronic kidney disease (CKD) and diabetes mellitus (DM) face elevated risks of cardiovascular disease (CVD), including heart failure.
  • Effective risk mitigation necessitates a multifaceted strategy encompassing lifestyle changes, blood pressure control, renin-angiotensin system inhibition, and SGLT2 inhibitors.

Purpose of the Study:

  • To review the comprehensive approach for mitigating cardiovascular risk in patients with CKD and DM.
  • To highlight recent clinical trial findings on nonsteroidal mineralocorticoid receptor antagonists (ns-MRAs) and glucagon-like peptide 1 receptor agonists (GLP-1 RAs) in this population.

Main Methods:

  • Review of recent large-scale randomized controlled trials.
  • Analysis of cardiovascular and kidney outcomes data from clinical trials involving ns-MRAs and GLP-1 RAs.

Main Results:

  • Recent trials demonstrate significant benefits of ns-MRAs and GLP-1 RAs on kidney and cardiovascular outcomes in patients with CKD and DM.
  • These agents have shown favorable safety profiles in this high-risk group.

Conclusions:

  • ns-MRAs and GLP-1 RAs are valuable additions to the comprehensive management of cardiovascular risk in patients with CKD and DM.
  • Further research is warranted to explore optimal combination therapies and treatment initiation strategies.
Abstract

Keywords:
chronic kidney diseasediabetesheart failure risk

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