Managing Chronic Kidney Disease in Patients With Diabetes

This transcript has been edited for clarity.

The American Diabetes Association has recently released the 2022 Standards of Medical Care in Diabetes. Among the highlights are the use of sodium-glucose cotransporter 2 (SGLT2) inhibitors to slow the progression of kidney and cardiovascular disease, the use of nonsteroidal mineralocorticoid receptor agonists, such as finerenone, to slow progression of kidney disease, and the use of the new race-free equation that is currently being implemented by the National Kidney Foundation and the American Society of Nephrology.

The SGLT2 inhibitors have been shown to slow progression of kidney disease, decrease albuminuria, and have a cardiovascular benefit in patients with and without diabetes.

Chronic kidney disease affects 37 million Americans and 850 million people around the world. Diabetes is the most common cause of kidney disease in the United States. Unfortunately, chronic kidney disease is an asymptomatic disease, so symptoms only appear very late in the disease when people are already needing dialysis or transplantation.

Therefore, screening for chronic kidney disease in high-risk populations, such as those who have diabetes, hypertension, or a family history of kidney disease, is of vital importance. Unfortunately, not everybody who is at high risk is being screened; therefore, it's very important that when you discuss it with your provider, if you're at high risk, you at least have this test annually.