Risk Stratification to Improve Care and Outcomes in Diabetic Kidney Disease
Abstract
Chronic kidney disease (CKD) is a global public health problem that affects one in eight Canadians, and nearly one in two with Type 2 diabetes (T2DM). It is widely recognized as a potent risk factor for cardiovascular (CV) outcomes, all-cause mortality, and progression to kidney failure requiring dialysis or transplant. End stage kidney disease is catastrophic for patients and families, but for most individuals who are identified as having high-risk CKD, progression is now preventable in this new era of guideline-directed medical therapy.
This review will summarize a new paradigm for diagnosis, staging, and management of CKD, that is centered around risk of progression rather than kidney function (eGFR or serum creatinine alone). We will describe the heterogeneity in the progression of kidney disease, as well as the clinical utility and usability of accurate risk prediction tools that can be used today in Canadian clinical practice.
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