Title : Chronic kidney Disease: Looking Beyond Diabetes

A “perilous Paradox” of our time…Some of the greatest human and economic burden is caused by one of the most treatable yet underdiagnosed conditions: chronic kidney disease. Our current practice is to diagnose too late, begin treatment too late, too conservatively and for too few people.

There are 537 million people with Diabetes all over the world and diabetes is not a mild disease. Diabetic patients have a macrovascular and microvascular complications1. CKD is one of the microvascular complications that increases over time after diagnosis of T2D. T2D is the first cause of CKD in diabetic patient and increase the risk of CVD.3

Globally there are 844 million with CKD. The problem the awareness of CKD between doctors is very poor and Life Expectancy is reduced in patients with Diabetes due to CKD and CVD.

We will speak about how to discover early CKD, the stages of CKD, how to treat and when to transfer patient to nephrologist. Many trials proved that SGLT2i  delay the progression  of CKD in diabetic and Non-diabetic patients.

Also discussing empa-kidney, credence and Dapa-kidney and the FDA approval of SGLT2i in patient with CKD either diabetic or not diabetic and discuss the New ADA guidelines 2026 and Joint ADA-KIDGO Consensus Report.

T1DM patients have to be screened yearly after 5 years of diagnosis, but T2DM have to be screened yearly at diagnosis. We screening CKD by doing spot urine ACR and eGFR, and diagnosed by persistent urine ACR>30 mg/g and or persistent eGFR<60ml/min/1.73m2 and or other evidence of kidney damage.

In people with T2D and CKD, SGLT2i should be used primarily for card-kidney o protection as they significantly reduce mortality, HF hospitalizations, and kidney failure, even with modest glycemic effects. Therefore, an SGLT2i should be added to existing glucose-lowering therapy specifically for its cardiovascular and kidney benefits.4 

Dr. Osama Elmaraghy a senior consultant of Diabetes. He graduated from Alex. University, Egypt and had P.G.D.D.  Leicester, UK. He is also sharing 6 chapters of Chronic Heart failure textbook, Elsevier, USA. April 2024, and sharing 2023 ICC/ISC Guideline for the management of HF. He has published many papers in world heart journal and European heart journal and shares many conferences as a speaker and chairperson. before he was working at Jahra hospital and Naeem diabetic center in Kuwait, now Dr. Osama working as a senior consultant of diabetes at Elite hospital, Álex Egypt.