What are the 4 pillars of CKD?
Scale of the problem
In the USA , a staggering 13% of people >18 years of age are estimated to have diabetes and 35% meet the criteria for prediabetes.
CKD and Type 2 Diabetes (DM2) together contribute to a major health burden for individuals, constitute a major public health burden and urgently need strategies to address them.
What can we do?
Early identification will allow early intervention to prevent kidney failure and cardiovascular complications of T2D by the simple expedient of UACR testing. Implementation of this strategy at a population level is key.
The 4 pillars of CKD care:
- ARBs or ACE inhibitors
- SGLT2 inhibitors
- Finerenone
- GLP1RAs.
But they should be built on the foundation of lifestyle modifications that include cessation of smoking, BP control, lipid management, physical activity, maintenance of a healthy weight and a diet low in sodium.
From being in a desert of therapeutic options prior to 2019, we are rich with multiple strategies to contain the kidney failure and cardiovascular epidemic in people with CKD and DM2.
Other resource
“The foundation and the four pillars of treatment for cardiorenal protection in people with chronic kidney disease and type 2 diabetes” Agarwal, 2022
Last Reviewed on 9 July 2024