CKD PROGRESSION IN T2D:

AN EVOLVING UNDERSTANDING OF THE DAMAGE BEING DONE

Luiza Caramori, MD, PhD, MSc, discusses the prevalence of CKD and T2D, as well as the driving factors behind CKD progression

3 MAJOR DRIVERS OF CKD PROGRESSION IN PATIENTS WITH T2D^1-4

Metabolic Drivers

Elevated HbA1c

Hemodynamic Drivers

Elevated BP
High intraglomerular pressure

Inflammatory
and Fibrotic Drivers

Presence and/or release of proinflammatory proteins and profibrotic proteins

CKD Progression

Current guideline-recommended therapies mainly focus on metabolic and hemodynamic drivers in patients with chronic kidney disease and type 2 diabetes, leaving inflammation and fibrosis largely unaddressed.5-7

Patients remain at risk of CKD progression even when their HbA1c and BP are controlled.1,2,8,9

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Current standard of care leaves patients vulnerable to a largely unaddressed driver of CKD progression: inflammation and fibrosis1-3,7

BP: blood pressure; CKD: chronic kidney disease; HbA1c: glycated hemoglobin; KDIGO: Kidney Disease Improving Global Outcomes; T2D: type 2 diabetes.

References:

Toth-Manikowski S, et al. J Diabetes Res. 2015;2015. doi:10.1155/2015/697010.
Alicic RZ, et al. Clin J Am Soc Nephrol. 2017;12(12):2032–2045.
Black LM, et al. J Histochem Cytochem. 2019;67(9):663–681.
Tesch GH, et al. Front Pharmacol. 2017;8. doi:10.3389/fphar.2017.00313.
Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. Kidney Int Suppl. 2013;3(1):1–150.
Kidney Disease: Improving Global Outcomes (KDIGO) Diabetes Work Group. Kidney Int. 2020;98(4S):S1–S115.
American Diabetes Association. Diabetes Care. 2021;44(suppl 1):S1–S232.
Duckworth W, et al; VADT Investigators. N Engl J Med. 2009;360(2):129–139.
The ACCORD Study Group. N Engl J Med. 2010;362(17):1575–1585.

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