• Clin Med (Lond) · May 2023

    Review

    The emerging pillars of chronic kidney disease: no longer a bystander in metabolic medicine.

    • Alexa Wonnacott.
    • Cardiff University, Cardiff, UK WonnacottAC@cardiff.ac.uk.
    • Clin Med (Lond). 2023 May 1; 23 (3): 254258254-258.

    AbstractChronic kidney disease (CKD) represents an enormous healthcare burden, the management of which has been stagnant for the last couple of decades, with blockade of the renin-angiotensin-aldosterone system (RAAS) the most potent tool available to retard kidney disease progression. In the new cardiometabolic era, sodium-glucose cotransporter-2 inhibitors (SGLT2i) have emerged as forerunners in addressing combined cardiorenal risk. This review summarises the evidence for SGLT2i use in diabetic and non-diabetic CKD and examines the risk:benefit profile in this population. Novel non-steroidal mineralocorticoid receptor antagonists are also considered as an emerging pillar of CKD management, and their role in optimising the cardiorenal health of patients with diabetic kidney disease is discussed.© Royal College of Physicians 2023. All rights reserved.

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