AHA24 Screening for Kidney Disease to Reduce CVD Risk: uACR and eGFR

7 A Toolkit for Health Care Professionals Screening for Kidney Disease to Reduce CVD Risk CKM syndrome is the pathophysiologic interplay between metabolic risk factors such as excess or dysfunctional adipose tissue, CKD and the cardiovascular system that leads to multiorgan dysfunction and a high rate of adverse cardiovascular outcomes.4-The current understanding of CKM syndrome CKM syndrome affects nearly all organ systems and has a particularly powerful impact on the risk and incidence of CVD.2-Summary 2x-4x Impaired kidney function can increase the risk of CVD two- to fourfold. 1-Results Consequently, the most common causes of death for people with diabetes and CKD are heart failure (HF) and atherosclerotic CVD (ASCVD), and only ≈10% of patients with CKD even survive to reach kidney failure. Conversely, the presense of CVD is associated with the development of CKD. 4-The current scientific understanding of CKM syndrome Screening Poor CKM health is a major contributor to morbidity and mortality that requires comprehensive approaches from childhood through old age. And because there are few, if any, symptoms in the early stages of CKD, broad-based screening may be the only viable approach to early detection and management.4-Evidence supporting CKM-related screening Comprehensive CKM screening that includes two common kidney parameters—estimated glomerular filtration rate (eGFR) and albuminuria as measured by urine albumin-creatinine ratio (uACR)—improves the potential to predict and prevent clinically relevant kidney and cardiovascular outcomes.3-Evidence supporting CKM-related screening If CKM is identified, clinicians have an expanding toolkit of therapeutic approaches to prevent or mitigate metabolic risk factors, to delay the progression of kidney disease and to reduce the associated CVD risk. A growing number of therapeutic agents include: • angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEi/ARB) • sodium-glucose transporter-2 inhibitors (SGLT2i) • a non-steroidal mineralocorticoid antagonist (nsMRA), (finerenone) • glucagon-like peptide-1 receptor agonists (GLP1-RA) • other incretin analogues4-Figure 3 These provide beneficial metabolic effects, kidney effects, or both, while also improving CVD outcomes which can improve CKM health.4-introduction

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