Welcome to Spotlight on Chronic Kidney Disease in Type 2 Diabetes on ReachMD. This medical industry feature, titled “Patients With Chronic Kidney Disease and Type 2 Diabetes Are at Risk of the 3 Main Drivers of Progression,” is sponsored by Bayer and is intended for physicians.
Here’s your host, Dr. Christos Argyropoulos.
Hello, I’m Dr. Christos Argyropoulos, and I’m Chief of Nephrology in the Department of Internal Medicine at the University of New Mexico School of Medicine. My research focuses on the epidemiology and care of patients with chronic kidney disease, or CKD, and end-stage kidney disease.
Patients with type 2 diabetes still face a substantial risk of CKD progression. Despite some improvements in managing CKD in type 2 diabetes, the incidence of end-stage kidney disease or kidney failure remains significant, indicating that there may be a missing link in the current standard of care. From my perspective, in order to address this gap, I think we need to focus on the 3 drivers of disease progression. The development and progression of CKD are driven by the combined effects of metabolic, hemodynamic, and inflammatory and fibrotic factors. For decades, the standard of care has focused on managing the metabolic effects, like elevated blood glucose, and hemodynamic effects, like elevated blood pressure. However, inflammatory and fibrotic factors, when driven by the mineralocorticoid receptor, or MR, are largely unaddressed. Inflammation and fibrosis, driven by the overactivation of the MR in the kidneys, can lead to declining kidney function and ultimately to end-stage kidney disease. For patients who reach end-stage kidney disease, 5-year survival rates are less than 40%. To protect the kidney from CKD progression, all 3 drivers of progression, including inflammation and fibrosis, need to be targeted.
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