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              Printable Handouts
Navigable Slide Index
- Introduction
- Outline: epidemiology and natural history
- Prevalence of CKD in DM
- High levels of morbidity and mortality
- CVD mortality
- Natural history of CKD in DM1
- Variabilities in DKD trajectory
- Outline: pathogenesis
- Glomerular capillary tuft
- Pathogenesis: hyperglycemia
- Pathogenesis: glomerulosclerosis
- Pathogenesis: diabetic nephropathy
- Outline: management
- Aims of DKD management
- Blood glucose control – T1DM
- Blood glucose control – T2DM
- Decreasing intra-glomerular pressure
- RAS blockade in DKD – landmark trials
- SGLT2 inhibition in CKD – putative mechanisms
- Landmark SGLT2i-CKD trials
- SGLT2i-CKD trials: important safety outcomes
- Well-accepted standard of care
- What about BP target in DKD?
- Intensive BP control in type 2DM: ACCORD study
- ACCORD: results
- ACCORD: caveats
- BP in DKD: what do guidelines say?
- MRA plus RAAS blockers in DKD
- Potential adverse effects of aldosterone
- MRA and CV outcomes
- MRA and kidney outcomes
- Finerenone in DKD: FIDELIO-DKD trial
- FIDELIO-DKD trial: major results
- FIDELIO-DKD: safety data
- SGLT2i in non-proteinuric CKD
- SGLT2i in non-proteinuric CKD: results
- SGLT2i in non-proteinuric CKD
- GLP-1 agonists in DKD: macroalbuminuria
- GLP-1 agonists in DKD: composite kidney outcomes
- DKD management – other factors
- DKD management – overview
Topics Covered
- Overview of Diabetic Kidney Disease (DKD)
- DKD epidemiology and natural history
- DKD Pathogenesis
- DKD management
- Variabilities in DKD trajectory
- SGLT2 inhibition in CKD
- ACCORD study
- Finerenone in DKD: FIDELIO-DKD trial
Links
Categories:
Therapeutic Areas:
Talk Citation
Upadhyay, A. (2023, March 30). Overview of diabetic kidney disease [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved October 31, 2025, from https://doi.org/10.69645/PIHC6575.Export Citation (RIS)
Publication History
- Published on March 30, 2023
Financial Disclosures
- Dr. Ashish Upadhyay has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.
A selection of talks on Cell Biology
Transcript
Please wait while the transcript is being prepared...
      
      
        
                  0:00
                
                
                  
                    Hello everyone. My name
is Ashish Upadhyay.
                  
                    I'm Associate Professor of
Medicine at Boston University,
                  
                    Chobanian & Avedisian
School of Medicine.
                  
                    The title of our talk today is
                  
                    Overview of Diabetic
Kidney Disease.
                  
                
              
                  0:15
                
                
                  
                    During the course of
the presentation,
                  
                    we will go through
                  
                    brief epidemiology
and natural history
                  
                    of diabetic kidney disease,
                  
                    pathogenesis of diabetic
kidney disease,
                  
                    and management of
diabetic kidney disease.
                  
                    First, let's talk about
                  
                    epidemiology and natural history
                  
                    of diabetic kidney disease.
                  
                
              
                  0:35
                
                
                  
                    Diabetic kidney
disease is defined as
                  
                    estimated GFR of less
than 60 ml/min or
                  
                    albuminuria as defined by urine
albumin creatinine ratio (UACR)
                  
                    of more than 30 mg/g
                  
                    in individuals with diabetes.
                  
                    It is estimated that
approximately half
                  
                    of individuals with
type 2 diabetes
                  
                    and a third of individuals with
                  
                    type 1 diabetes develop
diabetic kidney disease.
                  
                    It remains the
number one cause of
                  
                    kidney failure in most
parts of the world,
                  
                    but as you can see
from the table here,
                  
                    that looks at data from
                  
                    various national and
international cohorts,
                  
                    that there are major racial
and ethnic disparities
                  
                    in the prevalence of
diabetic kidney disease.
                  
                
              
                  1:23
                
                
                  
                    The importance of diabetic
kidney disease is
                  
                    because of its high level
of morbidity and mortality,
                  
                    as you can see from this data in
                  
                    5% of the Medicare sample
in the United States.
                  
                    The risk of diabetic
kidney disease
                  
                    is that it increases
the risk of death
                  
                    and in this particular sample,
                  
                    if you have diabetic
kidney disease,
                  
                    the risk of death was
6.1% over two years vs
                  
                    the risk of 0.3%
                  
                    without chronic kidney
disease with just diabetes.
                  
                
               
       
     
                    
                     
        
      
     
        
      
     
        
      
     
        
      
     
        
      
     
        
      
     
        
      
     
        
      
     
        
      
     
        
      
     
        
      
     
        
      
     
        
      
     
        
      
    