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Which patient which CKD and T2D would benefit the most from a GLP-1RA ? (eGFR (mL/min/1.73m2) + risk factor) eGFR: 18, BMI: 23 kg/m2 eGFR: 30, mod CV risk eGFR: 64, UACR: 250 mg eGFR: 15, UACR: 2500 mg A B C D #AskRenal #Nephpearls #glibinate

Is the 4th pillar now available⁉️ 👉Till 2019: RAASi are prescribed for nephroprotection in #DKD 👉In 2019, #CREDENCE trial: renal benefits of SGLT2i 👉In 2020, #Finerenone⬇️risk of CKD progression in patients with T2D 👉In 2024, #FLOW trial: #Semaglutide⬇️#CKD progression in T2D

Another outcomes trial win for GLP-1 medicines now with Semaglutide and the ESSENCE trial in metabolic liver disease with reduction in both inflammation and fibrosis #MASH novonordisk.com/content/nncorp…

💡 Tip 5: When adding #GLP1RA to insulin, monitor closely for hypoglycemia. Consider ⬇️ insulin doses especially in #CKD patients with reduced eGFR. #Diabetes #Nephpearls

💡 Tip 6: #GLP1RA therapy is excellent for weight reduction in diabetic patients. #Obesity #Diabetes #Nephpearls #NephTwitter

💡Tip 7: For patients with #CKD & diabetic retinopathy: 👉Baseline retinal screen before start #GLP1RA if not performed within the prior 12 months 👉Slowly⏫the dose to avoid rapid⏬A1C 👉Perform retinal screening within 6months to detect progression #NephTwitter #Nephpearls

💡 Tip 8: Educate your patients about the GI side effects of #GLP1RA. To⬇️ GI side effects, advice for 👉⏬ of meal size 👉⏬intake of fat & spicy food 👉Reassure that symptoms usually improve over time. #PatientEducation #Diabetes #Nephpearls

💡 Tip 9: #GLP1RAs can improve glycemic control without increasing hypoglycemia risk in #CKD patients, a major advantage over other diabetes medications. #NephTwitter #Nephpearls

In this recent RCT( #SMART trial) Semaglutide compared to placebo reduced UACR by −52.1% (95% CI -65.5, −33.4; P < 0.0001) in CKD, NON Diabetic patients with BMI > 27 kg m2 after 24 weeks sciencedirect.com/science/articl…

💡 Tip 10: though bunch of benefits, #GLP1RA have also some cons. Use with caution🚨 #Nephpearls #NephTwitter #Flow_trial

Which one of the following GLP1 RA have NOT shown renal benefit in CVOT ? #askrenal

In patients with DKD or HF, initiation of what two medications should be prioritized over others? #askrenal