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Therapeutic Considerations in Preventing Chronic Kidney Disease
Susanne B Nicholas1, Niloofar Nobakht1, Radica Z Alicic2,3
1Division of Nephrology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California, USA;
Annual Review of Medicine
|November 21, 2025
Summary
Early screening for chronic kidney disease (CKD) is crucial as most patients are unaware. Advanced therapies and multidisciplinary care are revolutionizing CKD management and reducing cardiovascular risks.
Area of Science:
- Nephrology
- Cardiology
- Endocrinology
Background:
- Chronic kidney disease (CKD) impacts millions, yet diagnosis rates are low due to asymptomatic progression.
- Cardiovascular disease is the leading cause of mortality in CKD patients.
- Cardiovascular-kidney-metabolic syndrome underscores the interconnectedness of heart, kidney, and metabolic health.
Purpose of the Study:
- To emphasize the importance of early CKD screening in at-risk populations.
- To highlight the role of diagnostic markers in CKD staging and risk assessment.
- To discuss advancements in CKD management and the integrated care approach.
Main Methods:
- Utilizing urine albumin-to-creatinine ratio and estimated glomerular filtration rate for CKD classification and risk stratification.
- Reviewing current guideline-directed medical therapies and standard-of-care treatments.
- Examining the impact of cardiovascular-kidney-metabolic syndrome on organ health.
Main Results:
- Urine albumin-to-creatinine ratio and estimated glomerular filtration rate effectively classify CKD stages and predict progression risk.
- Novel therapies like SGLT2 inhibitors and GLP-1 receptor agonists, alongside ACE inhibitors/ARBs, significantly improve CKD outcomes.
- A multidisciplinary approach is optimal for managing complex CKD cases.
Conclusions:
- Prompt CKD screening is essential for early intervention and improved patient outcomes.
- Integrated management of cardiovascular, kidney, and metabolic disorders is critical.
- Modern pharmacotherapies and collaborative care models represent a paradigm shift in CKD treatment.
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