A primary care guide to the screening and pharmacologic management of chronic kidney disease in people living with type 2 diabetes.

Abstract

This paper reports the expert opinions and recommendations made by primary care physicians (PCPs) to optimize screening and management of chronic kidney disease (CKD) associated with diabetes and presents algorithms to provide a practical and simplified guide for PCPs. Individuals living with type 2 diabetes (T2D) should be screened early and at regular intervals for CKD using both estimated glomerular filtration rate and urinary albumin-to-creatinine ratio testing. The risk of CKD assessed using the Kidney Disease: Improving Global Outcomes heatmap should be reviewed at least annually to optimize treatment to slow progression of CKD. Lifestyle modifications form the foundation of reducing CKD risk in individuals with T2D. A pillared approach to pharmacotherapy (renin-angiotensin system inhibitors, sodium-glucose cotransporter 2 inhibitors, a nonsteroidal mineralocorticoid receptor antagonist [finerenone], and glucagon-like peptide-1 receptor agonists) is recommended in individuals with CKD and T2D.