Martha Gulati, MD

Multidisciplinary Teams in CKD Management

How can multidisciplinary teams contribute to holistic patient care in managing CKD and associated risks? Why is ongoing education and collaboration across disciplines crucial in enhancing CKD care?

What protocols for screening and testing have you established for your health system to improve the outcomes of patients with type 2 diabetes at risk for or currently diagnosed with CKD? What are some challenges with implementing your protocol?

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Chronic kidney disease (CKD) in Type 2 Diabetes patients necessitates early detection to prevent progression and associated complications. Identifying at-risk patients involves considering factors such as hypertension, family history of kidney disease, and elevated blood glucose levels. Screening tests include estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR). Early detection is crucial as it allows timely intervention, potentially slowing disease progression and reducing cardiovascular risks. CKD is a significant risk factor for heart failure, making early detection vital for comprehensive cardiovascular risk management.

Panelists discuss how multidisciplinary teams can enhance holistic patient care in managing chronic kidney disease (CKD) and its associated risks, emphasizing the importance of ongoing education and collaboration across disciplines, along with established protocols for screening and testing in health systems and the challenges faced in their implementation for patients with type 2 diabetes at risk for or currently diagnosed with CKD.

Barriers to Implementing New CKD Treatments

What are the common barriers to implementing new CKD treatments and guidelines in clinical practice?

What role do pharmaceutical partners play in overcoming challenges in CKD treatment adoption?

Panelists discuss the common barriers to implementing new chronic kidney disease (CKD) treatments and guidelines in clinical practice, as well as the role of pharmaceutical partners in overcoming these challenges to enhance CKD treatment adoption.

Integration of Cardiovascular Care Into CKD Management

What role should cardiovascular risk management play in the treatment for these patients?

How can cardiovascular care be integrated into CKD management?

Cardiovascular risk management is crucial in treating patients with chronic kidney disease (CKD) due to the high prevalence of cardiovascular complications in this population. Effective management involves addressing traditional risk factors such as hypertension, dyslipidemia, and diabetes, alongside CKD-specific factors like mineral and bone disorders. Integrating cardiovascular care into CKD management requires a multidisciplinary approach, involving nephrologists, cardiologists, and primary care providers. This integration can be achieved through coordinated care plans, regular monitoring of cardiovascular health, and patient education to ensure adherence to lifestyle modifications and pharmacotherapy.

Panelists discuss the role of cardiovascular risk management for patients with chronic kidney disease (CKD) and how cardiovascular care can be effectively integrated into CKD management strategies.

Early-Stage vs Advanced CKD Treatment

What treatment options are available for patients in early-stage versus advanced CKD, and how should they be tailored to the patient's condition

What is the mechanism of action of nonsteroidal MRAs, such as finerenone, and how do they compare to other treatments?

Early-stage chronic kidney disease (CKD) management focuses on lifestyle modifications, blood pressure control, and glycemic management to slow progression. Advanced CKD requires more intensive interventions, including dialysis or transplantation. Treatment should be individualized based on the patient's comorbidities and disease progression. Nonsteroidal mineralocorticoid receptor antagonists (MRAs) like finerenone work by blocking mineralocorticoid receptors, reducing inflammation and fibrosis in the kidneys. They offer a novel approach compared to traditional treatments, potentially providing better cardiovascular and renal outcomes, especially in patients with diabetic kidney disease.

Panelists discuss the treatment options available for patients with early-stage versus advanced chronic kidney disease (CKD) and how these options should be tailored to individual patient conditions, as well as the mechanism of action of nonsteroidal mineralocorticoid receptor antagonists (MRAs) such as finerenone and their comparison to other treatment modalities.

Martha Gulati, MD

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