Thread by @lissabauer

Dr. Tuttle discussing diabetic CKD and benefits of relatively new med Finerenone #AACE2022

#diabetes is responsible for half of #CKD. CKD worsens CVD risk. 90% die from other cause before reaching ESRD #AACE2022 #endotwitter

#ckd -- screen, treat and refer. #kdigo to help us know when to do it #diabetes #AACE2022

Mineralocorticoid receptors increase inflammation and fibrosis --- blocking them decreases this (ie. Finerenone)

Finerenone clinical trials with positive results. Fidelio with #CVD outcome of 13% reduction, 23% reduction in kidney disease reduction #AACE2022

Finerenone dosing depending on eGFR, monitor potassium

#KDIGO updating this year for #CKD- should be published in the next few months. "harmonized" recommendations with ADA and AACE. SGLT2i and ARB/ACEi first line therapy. MRA and/or GLP1-RA for next line targeted therapy #aace2022

We aren't checking enough for albuminuria -- only 30-40% best picture -- 10% screening is the avg. We are also not treating them enough!

SGLT2i can decrease potassium so using with MRA can improve outcomes and decrease unwanted side effects