By 2050, CKD is likely to be the fifth leading cause of death globally. This report explains how CKD can be readily detected using simple, inexpensive tests, and that several widely available therapies substantially reduce the risks of kidney failure and cardiovascular disease, the two key serious consequences of the condition.
The authors emphasise that CKD often progresses silently for years, but two routine measurements are powerful predictors of future risk of disease progression: estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (uACR). Combining these tests enables accurate staging of CKD and identification of individuals at high risk of complications or death long before symptoms develop.
Since 2019, several large-scale randomised trials have reported that:
- Results from the EMPA-KIDNEY trial have shown that SGLT2 inhibitors reduce the risk of kidney failure by about one-third and heart-failure hospitalisation by about two-fifths, with benefits extending to people with and without diabetes;
- RAS inhibitors remain a standard of care for many patients, particularly for those with increased levels of albumin protein (ie uACR) in the urine;
- GLP-1 receptor agonists (notably subcutaneous semaglutide) have recently demonstrated significant reductions in major kidney outcomes and cardiovascular events in people with type 2 diabetes and CKD;
- Finerenone, a non-steroidal mineralocorticoid receptor antagonist, provides additional kidney and heart protection in patients with diabetes and albuminuria.
Read the full story on the Nuffield Department of Population Health website.