Kidney Week 2025 Annual Meeting-Clinical Management of Cardiovascular-Kidney-Metabolic Diseases: Protecting Kidney Health

Video Transcription

Video Summary

The session introduces the American Heart Association’s new Cardiovascular-Kidney-Metabolic (CKM) health initiative (2024), aimed at improving recognition and management of interconnected obesity/diabetes, cardiovascular disease, and chronic kidney disease (CKD). Dr. Roy Matthew reviews the public health problem: CKD is common, deadly, and poorly recognized by patients and clinicians; albuminuria testing remains underused, and prior preventive guidance (e.g., USPSTF) has not supported broad screening. The CKM staging framework elevates kidney metrics (eGFR and albuminuria) and includes social determinants of health. The new AHA PREVENT risk score also incorporates eGFR and albuminuria and predicts heart failure, potentially driving more testing and referrals. However, nephrology workforce shortages mean care models must evolve, favoring multidisciplinary clinics and implementation research (including the AHA CKM implementation network) to scale effective care.<br /><br />Dr. Suzanne Nicholas summarizes the modern pharmacotherapy landscape targeting CKM mechanisms (inflammation, fibrosis, hyperfiltration): renin-angiotensin system blockade, SGLT2 inhibitors, GLP-1 receptor agonists, and finerenone. She maps trial eligibility across eGFR/UACR “heat map” risk categories and highlights evidence for kidney and cardiovascular benefits, with emerging support for combination therapy (e.g., greater albuminuria reduction). Key barriers include low screening, clinician uptake, adherence burden, and medication cost; proposed solutions include EHR-based prompts and greater use of clinical pharmacists.<br /><br />Dr. Amy Mottl applies these concepts through patient cases, emphasizing shared decision-making, earlier combination therapy for high-risk patients, monitoring expected eGFR “dips” after SGLT2 initiation, and using GLP-1/GIP agents for obesity and HFpEF, while acknowledging real-world access constraints.

Asset Subtitle

Moderator(s): Alan Kliger, Luxcia Kugathasan

Presentation(s):

Nephrology and the American Heart Association's CKM Framework in Research and Clinical Care - Roy Mathew
Saving Kidneys, Heart, and Lives: Understanding the Landscape of Pharmacotherapies - Susanne Nicholas
Working Through Patient Complexity: Case Studies and Audience Interaction - Amy Mottl

ASN thanks the ASN Diabetic Kidney Disease Collaborative Task Force for assistance with this session.

Meta Tag

Date 11/7/2025

Pathway 1 Diabetic Kidney Disease

Pathway 2 Hypertension and Cardiorenal Disorders

Session ID 507327

Keywords

American Heart Association

Cardiovascular-Kidney-Metabolic (CKM) health

CKM staging framework

chronic kidney disease (CKD)

eGFR

albuminuria

urine albumin-to-creatinine ratio (UACR)

AHA PREVENT risk score

heart failure prediction

obesity and diabetes management

social determinants of health

SGLT2 inhibitors

GLP-1 receptor agonists / GLP-1-GIP agents

finerenone (nonsteroidal MRA)

multidisciplinary care models and implementation research