Dr. Amit Sharma, a board-certified internist, nephrologist, and hypertension specialist, discusses the obstacles we face when treating kidney disease.
Chronic kidney disease (CKD) is highly correlated with cardiovascular risk, demonstrated in the form of coronary artery disease, heart failure, or sudden cardiac death. Cardiovascular events are higher in patients with early CKD compared with the general population, and more so with patients who are in its advanced stages.
Cardiovascular complications are actually the primary cause of death in this high-risk, CKD population.
All constituents, whether from the academic or commercial worlds, continue to seek understanding as to what drives kidney disease overall and what drives its progression. One goal is to unearth how precision medicine can better target therapeutic use to patient needs.
Recently, Elise Wilfinger from Renalytix discussed this very topic with Dr. Amit Sharma, a board-certified internist, nephrologist, and hypertension specialist. Dr. Sharma is the U.S. Vice President Cardiovascular & Renal, Medical Affairs at Bayer Pharmaceuticals, serves on the board of directors for ASN’s Kidney Health Initiative (a public-private partnership with the FDA and Department of HHS), and holds various leadership positions with the National Kidney Foundation’s Patient Network and its National Leadership Council.
Dr. Sharma began by comparing patient outcomes for cardiovascular and kidney disease, highlighting the fact that outcomes have not been as strong in kidney disease as they have been in some cancer or singular cardiovascular diseases due to three reasons:
We haven’t had the right testing to provide clinicians insights into which patients will progress and who will need more resources
The majority of patients with kidney disease, specifically diabetic kidney disease, are unaware that they have it
Most physicians don’t have time to treat multiple problems
But according to him, the COVID-19 pandemic has taught us that virtual health can work, and with advancements in genotyping, phenotyping, and biomarkers, clinicians are able to capture real-time data and better inform the interventions required for their patients.
Moving to the treatment landscape for kidney disease, according to Dr. Sharma, some of these therapeutics can be used for cardiovascular disease, and with the development of new SGLT2 therapeutics, we can better optimize kidney care and also mitigate cardiovascular events.
And even though we have a long way to go when it comes to these new therapeutics, he believes that they will still drive better patient compliance. And in order to continue moving in the right direction, clinicians need to continue to keep sight of what the patient wants and collaborate with organizations to help prevent kidney disease.