Managing Chronic Kidney Disease in Patients With Diabetes
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, and the use of nonsteroidal mineralocorticoid receptor agonists, such as finerenone, to slow the progression of kidney disease. The SGLT2 inhibitors have been shown to slow the progression of kidney disease, decrease albuminuria, and have a cardiovascular benefit in patients with and without diabetes. 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 diseases in high-risk populations, such as those who have diabetes, hypertension, or a family history of kidney disease, is of vital importance. Screening with two tests: 1) S. creatinine-estimate glomerular filtration rate or GFR for short 2) Urine albumin-how much protein is coming down in the urine, which tells us how much damage the kidney has.