Diabetes and the kidney

Module 6: The later stages of diabetic kidney disease – prevention, delay and management

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CME Credits: 1
Module duration: 1 hour
Launch date: Spring 2020 (version 1)
Updated: Spring 2023 (version 2)
Expiry date: March 2027
Audience: Diabetes and Metabolism Specialists (Subspeciality), Endocrinologists (Subspeciality), General Physicians (Advanced), Nephrologists (Advanced)

Hi. My name is Per-Henrik Groop. I’m Professor of Internal Medicine at the University of Helsinki, in Finland. I’m also Chief Physician at the Division of Nephrology at Helsinki University Hospital and it’s my great pleasure today to talk to you about end-stage renal disease. End-stage renal disease is something we see not only in patients with diabetes but also in patients without diabetes, and it means that the patient has lost kidney function and we have an eGFR below 10 ml/min. So, that’s the stage when we have to consider renal replacement therapies, which means dialysis and kidney transplantation.

This module examines the later stages of diabetic kidney disease (DKD), including how it may affect a person’s general health and diabetes control, and what efforts should be made to prevent or delay its progression.

Wiviott SD, Raz I, Bonaca MP, Mosenzon O, Kato ET, Cahn A, Silverman MG, Zelniker TA, Kuder JF, Murphy SA, Bhatt DL, Leiter LA, McGuire DK, Wilding JPH, Ruff CT, Gause-Nilsson IAM, Fredriksson M, Johansson PA, Langkilde AM, Sabatinr MS on behalf of the DECLARE_TIMI 58 Investigators. Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med 2019;380(4):347-357.
http://pubmed.ncbi.nlm.nih.gov/30415602


Perkovic V, Jardine MJ, Neal B, Bompoint S, Heerspink HJL, Charytan DM, Edwards R, Agarwal R, Bakris G, Bull S, Cannon CP, Capuano G, Chur PL, de Zeeuw D, Greene T, Levin A, Pollock C, Wheeler DC, Yavin Y, Zhang H, Zinman B, Meininger G, Brenner BM, Mahaffey KW; CREDENCE Trial Investigators. Canagliflozin and renal outcomes in type 2 diabetes and nephropathy. N Engl J Med. 2019 Jun; 380:2295–2306.
https://www.ncbi.nlm.nih.gov/pubmed/30990260

Learning Outcomes

By the end of this module, you will be able to:

Explain current and future strategies for people in the later stages of diabetic kidney disease (DKD) to prevent, delay and manage their condition

Identify possible roles for SGLT-2 inhibitors for the treatment of DKD emerging from clinical trial results

Develop management plans for people with diabetes and DKD to prevent, delay or manage their condition. including in the later stages of DKD


This module includes self-marked assessments, such as knowledge checks and/or case studies, as well as a marked final assessment, which you can attempt up to five times. To complete the module, you must review all chapters, pass the final assessment (80% pass mark), and fill in our feedback form.


Contributors

Professor
Per-Henrik Groop
Author
Professor
Sally Marshall
Expert Reviewer
Professor
Patrik Finne
Assessment Setter
Assessment Setter
Assessment Setter