CKD PROGRESSION
IN T2D:

AN EVOLVING UNDERSTANDING OF THE DAMAGE BEING DONE

3 MAJOR DRIVERS OF CKD PROGRESSION
IN PATIENTS WITH T2D1-5

Metabolic driver of CKD

Metabolic Drivers

  • Elevated HbA1c

Hemodynamic driver of CKD

Hemodynamic Drivers

  • Elevated BP
  • High intraglomerular pressure
 
Inflammatory and fibrotic drivers

Inflammatory and Fibrotic Drivers

  • Presence and/or release of proinflammatory proteins and profibrotic proteins

CKD Progression

The Mode of Disease of CKD in Patients with T2D

YYMMDD Author/Uploaded by

THE MODE OF DISEASE OF CKD IN PATIENTS WITH T2D VIDEO

Therapies currently recommended for patients with chronic kidney disease and type 2 diabetes by KDIGO and the EASD mainly focus on metabolic and hemodynamic drivers, leaving inflammation and fibrosis largely unaddressed.6-8

Patients remain at risk of CKD progression even when their HbA1c and BP are controlled.1,2,9,10

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See how CKD can often become a large burden for patients11-14
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BP: blood pressure; CKD: chronic kidney disease; EASD: European Association for the Study of Diabetes; HbA1c: glycated hemoglobin; KDIGO: Kidney Disease Improving Global Outcomes; T2D: type 2 diabetes.

References:

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  • Alicic RZ, et al. Clin J Am Soc Nephrol. 2017;12(12):2032–2045. Return to content
  • Alicic RZ, et al. Adv Chronic Kidney Dis. 2018;25(2):181–191. Return to content
  • Black LM, et al. J Histochem Cytochem. 2019;67(9):663–681. Return to content
  • Tesch GH, et al. Front Pharmacol. 2017;8. doi:10.3389/fphar.2017.00313. Return to content
  • Kidney Disease: Improving Global Outcomes (KDIGO) Diabetes Work Group. Kidney Int. 2020;98(4S):S1–S115. Return to content
  • Cosentino F, et al; ESC Scientific Document Group. Eur Heart J. 2020;41(2):255–323. Return to content
  • Tuttle KR, et al. Am J Kidney Dis. 2021;77(1):94–109. Return to content
  • Duckworth W, et al; VADT Investigators. N Engl J Med. 2009;360(2):129–139. Return to content
  • The ACCORD Study Group. N Engl J Med. 2010;362(17):1575–1585. Return to content
  • Afkarian M, et al. J Am Soc Nephrol. 2013;24(2):302–308. Return to content
  • Wen CP, et al. Kidney Int. 2017;92(2):388–396. Return to content
  • Amod A, et al; DEVOTE Study Group. Diabetes Ther. 2020;11(1):53–70. Return to content
  • Thomas MC, et al. Nat Rev Dis Primers. 2015;1. doi:10.1038/nrdp.2015.18. Return to content