Aja Best is a patient advocate who was diagnosed with CKD during pregnancy, eventually requiring dialysis and a kidney transplant.

Crisis Point: Curbing the Chronic Kidney Disease Epidemic

Our mini-docuseries has returned, taking a comprehensive look at public health crises affecting the United States today, with global implications tomorrow. If the crisis point is the moment where a crisis will worsen or begin to get better, the question remains: where are we now?

CKD’s Emergence As A Public Health Crisis: Next Steps for Halting the Silent Spread

In recognition of National Kidney Month, this episode addresses the growing burden of 

 and its emergence as the biggest public health crisis of our time.

CKD is estimated to affect 35 million adults in the US alone, but despite its widespread impact, it often flies under the radar. In many patients, the disease progresses silently and goes undetected until it reaches advanced stages when symptoms appear but treatment options are limited. While there has been no single cause of the CKD crisis, the growing prevalence of risk factors like diabetes, hypertension, and obesity has intensified the threat posed by CKD, setting the stage for a surge in cases that could overwhelm healthcare systems and disrupt countless lives.

Current estimates suggest 9 out of 10 people with kidney disease are unaware they have it, and 1 in 3 of those with severely reduced kidney function but who are not yet on dialysis are unaware they have kidney disease.

In addition to the need for better public awareness to facilitate early detection and treatment of CKD, patient-focused multidisciplinary care is also essential for improving outcomes. The burden of CKD cannot fall on nephrologists alone. Addressing this crisis requires a collaborative effort across the entire health care system but must be tailored in a way that ensures complete, equitable care for the patient.

Be sure to check out part 1 of this episode, which delves into the complex challenges surrounding CKD, exploring the various factors contributing to its growth, the importance of early detection and intervention, and the need for heightened public awareness.

In part 2, the conversation shifts to the importance of collaborative, multidisciplinary care that maintains a focus on patients’ wants and needs as well as the future of CKD care.

Brief descriptions of the speakers featured in this project are provided below:

, chief medical officer of the American Kidney Fund

, associate clinical professor of medicine in the division of nephrology at Icahn School of Medicine at Mount Sinai and chief medical officer of the National Kidney Foundation

, chief executive officer of Carna Health

, a patient advocate who was diagnosed with CKD during pregnancy, eventually requiring dialysis and a kidney transplant

 to see other episodes on improving health equity in eye care, disparities in cardiovascular health, insulin access in the United States, physician burnout across healthcare, and the ongoing obesity crisis.

American Kidney Fund. Quick kidney disease facts and stats. Accessed March 5, 2025. 

https://www.kidneyfund.org/all-about-kidneys/quick-kidney-disease-facts-and-stats

In part 2 of this episode of Crisis Point, 3 nephrology experts and a patient advocate discuss strategies to address the CKD crisis.

Aja Best

Andrew J. Cutler, MD

Key Clinical Trial Insights from ACC 2025 with Deepak Bhatt, MD, MPH, MBA​

Thousands of cardiovascular professionals from around the world converged in Chicago for the 

American College of Cardiology’s 2025 Annual Scientific Session (ACC.25)

, where cutting-edge science and clinical breakthroughs took center stage. With more than 4,750 abstracts accepted, 1,300 expert faculty, and 53 late-breaking clinical trials, the meeting delivered a high-impact snapshot of where cardiology is headed.

As a follow-up to our ACC.25 preview, our editorial team caught up with Deepak Bhatt, MD, MPH, MBA, director of Mount Sinai Heart and the Dr. Valentin Foster Professor of Cardiovascular Medicine at the Icahn School of Medicine, for his take on the most important data to emerge from the meeting. In this video interview, Dr. Bhatt breaks down three headline-grabbing studies (REVERSE-IT, ALPACA, and ADVANCE-HTN) and revisits the trials he flagged as ones to watch ahead of the conference (STRIDE, SOUL, and DapaTAVI).

Bentracimab, an investigational reversal agent for ticagrelor, rapidly restored clotting function in patients facing urgent surgery or major bleeding in the REVERSE-IT trial. Currently under FDA review, bentracimab could address a major clinical gap, as no approved reversal agent exists for ticagrelor.

The study’s primary endpoint—percent inhibition of P2Y12 Reaction Units (PRU)—dropped significantly within hours post-dose (

 < .0001), confirming rapid reversal. Results were consistent across surgery and bleeding groups, and across subgroups by age and sex.

Lepodisiran, a long-acting siRNA therapy, led to profound and sustained reductions in lipoprotein(a) [Lp(a)] levels for up to 18 months in the ALPACA trial. In the placebo-controlled study of 320 patients, those receiving two 400 mg lepodisiran doses experienced a 94.8% reduction in Lp(a) at 180 days, with levels still 74.2% lower at 1.5 years.

With no approved treatments available for elevated Lp(a)—a major cardiovascular risk factor—lepodisiran could represent a significant advance if long-term efficacy and safety are confirmed. Eli Lilly has initiated a Phase 3 clinical development program, ACCLAIM-Lp(a).

Lorundrostat significantly lowered blood pressure in patients with uncontrolled hypertension in the ADVANCE-HTN trial. The randomized, placebo-controlled trial included 285 patients already on 2 to 5 antihypertensive medications who still experienced elevated blood pressure.

At 12 weeks, patients receiving lorundrostat experienced greater reductions in 24-hour average systolic blood pressure (SBP) compared to placebo, with placebo-adjusted drops of -7.9 mmHg and -6.5 mmHg in the 50 mg and 50–100 mg dose groups, respectively. At week 4, patients on lorundrostat were also three times more likely to reach a 24-hour average SBP below 125 mmHg.

Oral semaglutide reduced major adverse cardiovascular events (MACE) by 14% over 4 years in high-risk patients with T2D in the SOUL trial. Among 9650 patients with ASCVD, CKD, or both, oral semaglutide lowered the composite rate, primarily driven by a 26% reduction in non-fatal heart attacks.

As the first trial to confirm cardiovascular benefit with an oral GLP-1, SOUL could offer a meaningful alternative for patients unwilling or unable to use injections. While gastrointestinal side effects were more common with oral semaglutide, serious adverse events were slightly less frequent than with placebo.

Semaglutide 1.0 mg (Ozempic) significantly improved functional outcomes in patients with peripheral artery disease (PAD) and type 2 diabetes (T2D) in the STRIDE trial. Over 52 weeks, patients receiving semaglutide experienced a 13% improvement in walking distance versus placebo (P = .0004), with improvements in pain-free walking distance, ankle-brachial index, and quality-of-life gains versus placebo.

STRIDE marked the first trial of a GLP-1 receptor agonist in PAD and could position semaglutide as the first therapy in over 20 years to improve PAD function.

Daily dapagliflozin reduced the risk of death or worsening heart failure by 28% at one year in patients undergoing transcatheter aortic valve implantation (TAVI) in the DapaTAVI trial. The benefit was driven by a 37% reduction in worsening heart failure, while all-cause mortality was numerically lower but not statistically significant.

Conducted across 39 centers in Spain, the study included a mostly elderly population, often excluded from prior SGLT2 trials. Dapagliflozin showed a favorable safety profile overall, although it was linked to higher rates of genital infections and hypotension.

Relevant disclosures for Bhatt include Amarin, AstraZeneca, Sanofi, Pfizer, Roche, Amgen, and Eli Lilly and Company, among others.

Deepak Bhatt, MD, MPH, MBA, explores high-impact trials from ACC.25, including REVERSE-IT, Alpaca, ADVANCE-HTN, SOUL, STRIDE, and DapaTAVI.

Key Clinical Trial Insights from ACC 2025, with Deepak Bhatt, MD, MPH, MBA​

Deepak Bhatt, MD, MPH, MBA

Panelists discuss how key nonpharmacological interventions include vaccinations to prevent infections, pulmonary rehabilitation to improve function, and lung cancer screening for high-risk patients to enable early detection.

Vaccination and Pulmonary Rehabilitation in COPD

Video content above is prompted by the following:

What nonpharmacological interventions should one consider for their patients, including vaccination, pulmonary rehabilitation, and lung cancer screening?

Emily Wan, MD MPH

To watch the video series component of this episode, click here.

0:01:21 The definition and prevalence of agitation in Alzheimer’s disease

0:05:17 The International Psychogeriatric Association Agitation Workgroup agitation reduction and prevention psychogeriatric consensus algorithm

0:13:15 Managing agitation in long term care facilities

0:17:52 Nonpharmacological treatment options

0:20:49 Pharmacological treatment options

0:22:32 Brexpiprazole for treatment of agitation

0:23:17 Mechanism of action and clinical trial data of brexpiprazole

0:26:58 Managing expectations with brexpiprazole

0:28:28 Managing acute breakthrough agitation

0:31:10 Emerging agitation agents on the horizon

0:32:27 Collaborating with Centers of Medicare and Medicaid on using antipsychotic agents in long term care facilities

Expert geriatric psychiatrists explore a frequently encountered symptom in Alzheimer’s disease, agitation. We will discuss its impact on patient’s and care giver’s quality of life, the current standard of care and the first FDA approved agent for treatment of agitation symptoms in Alzheimer’s disease.

Advances in Treatment of Agitation Associated with Dementia Due to Alzheimer’s Disease

George Grossberg, MD

 I’d love for you to share with the viewers what strategies you have implemented based on your experiences to educate patients about their journey. Because that’s so important, as John has said, about making this a patient-centered diagnosis. What’s a day in the life of Dr Maron and Dr Ommen in how you approach these issues?

 I’ll go first. Like I’m sure Steve does, we spend a lot of time with patients when they come and do our own education with them, along with our health care team and nurse practitioners to educate patients about the disease. We spend a lot of time on education, reassurance, putting these issues that we’ve talked about in perspective, and doing a lot of shared decision-making, going through treatment options. At the end of the day, we try to deliver the message that hypertrophic cardiomyopathy [HCM] is a highly treatable disease. It’s going to probably be more so in the future, but even today it’s very treatable and a disease that’s compatible with normal life expectancy and good quality of life for the vast majority of patients. That’s the messaging that we give to patients the best that we can.

 I’d echo the same thing. Patients come to us after having done their own education attempts on the internet, freaked out with wide eyes because they’ve read all the dramatic stories that are available, and we have to remind them that people who have normal lives don’t usually blog about it.

I’d like to reiterate the same words about HCM in the modern era. We’ve gone from an era where it was 100% fatal in 1958 when Donald Teare described it to a 6% annual mortality in the 1980s to an annual mortality that’s the same as the general population. It’s a highly treatable disease for most patients. There are patients in whom there are issues. This discussion wasn’t about sudden cardiac arrest, which would be another 2 hours. Then there are quality-of-life issues that some patients have. But it’s a highly treatable disease and we’re getting more tools in our toolbox for the future, which is exciting.

 That’s super. Javed, any final thoughts you want to share?

 My final thought is that we have these therapies and we want to do anything and everything that we can for the patients to not unnecessarily suffer. The question is how do we educate the clinical community at large to refer the patients to the appropriate centers and to diagnose and screen these patients? While the specialists are very interested in and have a lot of these tools, more mass education about this disease would also be needed.

 From an administrator’s point of view, let me ask you to put that hat on for a second. When you’re looking at making recommendations for clinicians who are interested in getting involved in this, what things would you say are needed in terms of understanding things like catheter-based approaches, surgical approaches, and volume, which you talked a bit about? What do you think about setting certain expectations?

 You can modify behavior quite a lot by creating appropriate incentive structures in terms of education, screening, and quality metrics. You can also set up tools. We live in this digital age and everybody is on an electronic health record. A lot of the education and best practice advisories can be had for our patients in this era. Education and reminder systems are easier in the current day and age.

 Super. John, I’m going to turn to you last. You always keep the patient in the center. I’m curious to hear your final thoughts.

 First, I’m humbled by the expertise at this panel and not being an HCM expert. I feel a tremendous need to think about the infrastructure for elevating the quality of care throughout the nation. What does that entail? Does it entail thinking about algorithms, building shared decision-making tools, integrating routine assessments of health status with the KCCQ [Kansas City Cardiomyopathy Questionnaire], and coming up with very practical management strategies so that you don’t have to be in Boston or Rochester, Minnesota, to get high-quality care?

 Or Kansas City. That’s what I’m left with. It’s a complicated disease, but it’s an exciting disease. As more treatment options become available, there’s a greater call for thinking about the infrastructure of delivering high-quality patient-centered care. That’s what I’d like to see us move toward so that we can all benefit from the advances being made.

 Super. That’s a great way to conclude. I want to thank all of you for this rich and informative discussion. I want to thank you, our viewers, for watching this 

. If you enjoyed the content, please subscribe for our e-newsletters to receive upcoming 

 and other great content right in your inbox. I’m Jim Januzzi from the Massachusetts General Hospital. Thanks very much for joining.

Expert cardiologists share strategies for educating patients on the treatment and management of hypertrophic cardiomyopathy. 

Patient Education of HCM

John A. Spertus, MD, MPH

 For take-home messages, the first and foremost is that people with sickle cell disease want to live normal, active lives. They don’t want to spend their time in the hospital. If you’re seeing them in front of you, there’s a reason, and there are always strategies to try to improve the overall quality of life for people with sickle cell disease. We should provide them with all of the opportunities available to try to make their lives better. There has been a lot of structural racism that has affected how patients with sickle cell disease are treated, both in the emergency department and in lots of places. We have to overcome that structural racism and make sure our patients have every opportunity to live a long healthy life.

 It is so important for hematologists and primary care providers who take care of patients with sickle cell disease to first, establish the trust. Many of our patients suffer from what they perceive to be bias against them when they come in for crisis. Please take the time to listen to them and to get to know them because once you can establish that trust, we can really improve the lives of our patients with sickle cell. Second, sickle cell disease-modifying therapies are needed. We can no longer think that sickle cell pain is simply, “Am I in a painful event, or am I not in a painful event?” Please understand the importance that the organ complications over time are the life-limiting complications of sickle cell. Getting patients to accept sickle cell disease-modifying therapies from an early stage of life is vital.

Third, understand the impact of sickle cell on quality of life. Please pay attention to schoolwork, how sickle cell affects their relationships, how it can affect them holding a job, and view our patients in the whole because sickle cell impacts every aspect of their lives. In several cases, we’re the only providers they have to turn to for addressing this multi-socioeconomic impact of sickle cell. Please look out for the entire patient, not just the sickle cell pain event.

 It’s important that we take a life span perspective when we treat people with sickle cell disease. Many of the complications that we see in adulthood start in pediatrics, but don’t necessarily cause problems for children. But that doesn’t mean that they aren’t important. I’ll take the kidney as an example. We start seeing a lot of microscopic proteinuria, the microalbuminuria in children with sickle cell disease as adolescents. It can be almost a third of adolescents who have sickle cell anemia who develop microalbuminuria, but they don’t have renal insufficiency as children. Many of them still have hyperfiltration, where their creatinine levels are lower than normal. As those patients move into their 20s and 30s, we see the development of chronic renal disease, and with that, worsening anemia and disease progression in other ways. It’s important that we intervene when people with sickle cell disease are children because that’s where these end-organ complications start.

Sophie M. Lanzkron, MD, MHS; Jeffrey D. Lebensburger; and John J. Strouse, MD, PhD, share key takeaways and closing thoughts for the management of sickle cell disease.

Advice for Sickle Cell Disease Management

John J. Strouse, MD, PhD

 What’s really important—and we’re not here to give advice to the manufacturer of inclisiran—is the reputation a drug develops when it’s brought to the marketplace. It sticks. To Dean’s point, if you look at data published by Seth Baum and others, they found that the utilization of PCSK9 was somewhere about 0.3% of those who were eligible.

What happened was you had the insurance payers creating these incredible speed bumps. It didn’t really matter. The manufacturers of PCSK9 inhibitors cut their price in half. As Dean, Manesh, and Linda have said, the access to the PCSK9 inhibitors has certainly become easier. But the doctors just aren’t interested in prescribing. As far as they’re concerned, it’s a drug that’s very difficult for patients to access. It’s an “expensive” drug. I urge the manufacturer of inclisiran to think the process through, so that when this drug finally comes to market, it is accessible. 

Otherwise, you’re going to have the same issues that we face with PCSK9 inhibitors. Perhaps we need to inject some artificial intelligence into value-based care instead of what seems to be artificial insanity. We need to be able to count on really good algorithms to determine appropriate use for these compounds.

I still have heterozygotes being turned down for PCSK9 inhibitors. It’s insanity out there. What we really need is really good artificial intelligence, not artificial insanity, in terms of making sure these drugs are being used in the appropriate patient at the appropriate time.

 Norman, that was a wonderful take-home message. In fact, I’m going to start with Dean, Manesh, and Linda; you’ll be last. Give me a similar take-home message, something you think our audience needs to hear from you. Dean?

 In secondary prevention, the LDL [low-density lipoprotein] goal is less than 70 mg/dL and probably lower for all our patients. That’s going to require combination therapy, the best statin dose you can get them on, and then other drugs.

If the cost of the medicine is too expensive, then use ezetimibe. For primary prevention, family history, pay attention to risk-enhancing factors in the guidelines and calcium scoring. That’s how we can get these patients treated earlier, so we’re not in the situation where they’ve already had events and you’ve got to be that much more intensive with regard to their treatment.

 We’re at the age where we have an explosion of possible therapies for our patients, which is great. The take-home message for me is this isn’t about cardiology or specialty care; it’s about primary care. This is about getting the message and the care pattern and the access to the primary care. That’s how we’re going to affect the population health, by getting these therapies—statin, inclisiran if it comes on the market, PCSK9 as we’ve just heard—into the hands of our primary care doctors and getting them comfortable with having the conversation with patients to get the therapies to them.

 That’s a great comment. Linda, you have the last take-home.

I just want to reemphasize lifestyle. Diet is absolutely critical. You can have somebody who is not at goal and they’re eating a terrible diet, and they can have really good results from changing that diet. Using our licensed nutrition folks and getting these people to improve their diet is very much a part of the picture.

 Thank you very much. I’m Dr Keith Ferdinand for HCPLive®. We’ve had a rich and informative discussion. Linda, Dean, Norm, and Manesh have given us a wealth of ideas and information, reviewed data, and given some opinions on where we are now with the intent of lowering risk in patients who are high risk, including the FH [familial hypercholesterolemia] patients, patients with ASCVD [atherosclerotic cardiovascular disease].

If you enjoyed watching this HCPLive® Peer Exchange, if you enjoyed the content, please subscribe to our e-newsletters to receive upcoming Peer Exchanges and other great content right in your in-box. Thank you very much for listening to this program.

Final thoughts from expert KOLs regarding treatment decisions and how they relate to patient accessibility when manage dyslipidemia. 

Treatment Decisions and its Relation to Patient Accessibility  

Norman Lepor, MD, FACC, FAHA, FSCAI

developments in the treatment landscape of plaque psoriasis, novel oral systemic treatment options to alleviate the burden of this chronic disease.

A Patient-Centric Medcast on the Journey Through Moderate Plaque Psoriasis

07:48 Absence of treatment or under treatment of plaque psoriasis

12:50 Prescribing novel systemic medications in plaque psoriasis as an advanced practice provider

15:46 Classifying moderate disease in plaque psoriasis

19:43 Getting payer approval for your patients with plaque psoriasis

23:18 Novel oral systemic treatments for plaque psoriasis

25:03 Pivotal clinical trial data on deucravacitinib

27:58 Deciding on aprimilast versus deucravacitinib for your patients with plaque psoriasis

31:53 Mechanism of action of deucravacitinib

38:13 Selecting a therapy in the evolving treatment landscape for your patient with plaque psoriasis

43:08 Educating your patients on injectables and orals systemic treatments

Advanced practice providers in dermatology discuss exciting developments in the treatment landscape of plaque psoriasis. Listen to their insights into the often-challenging journey patients go on. The arrival of novel oral systemic treatment options offers opportunities to alleviate the burden of this chronic disease.

A Patient-Centric Medcast on The Journey Through Moderate Plaque Psoriasis

Terry Faleye, MPAS, PA-C

In this MEDcast episode,Raj Chovatiya, MD, PhD, and George Han, MD, PhD interview Vivian Shi, MD, FAAD, to discuss the latest clinical evidence on the management of atopic dermatitis (AD) in different age groups and patient factors to consider when selecting a treatment for AD.

Authors