We noted you are experiencing viewing problems
-
Check with your IT department that JWPlatform, JWPlayer and Amazon AWS & CloudFront are not being blocked by your network. The relevant domains are *.jwplatform.com, *.jwpsrv.com, *.jwpcdn.com, jwpltx.com, jwpsrv.a.ssl.fastly.net, *.amazonaws.com and *.cloudfront.net. The relevant ports are 80 and 443.
-
Check the following talk links to see which ones work correctly:
Auto Mode
HTTP Progressive Download Send us your results from the above test links at access@hstalks.com and we will contact you with further advice on troubleshooting your viewing problems. -
No luck yet? More tips for troubleshooting viewing issues
-
Contact HST Support access@hstalks.com
-
Please review our troubleshooting guide for tips and advice on resolving your viewing problems.
-
For additional help, please don't hesitate to contact HST support access@hstalks.com
We hope you have enjoyed this limited-length demo
This is a limited length demo talk; you may
login or
review methods of
obtaining more access.
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 December 3, 2024, from https://doi.org/10.69645/PIHC6575.Export Citation (RIS)
Publication History
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 Gastroenterology & Nephrology
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.