The ASN Diabetic Kidney Disease Collaborative Initiative: Pursue Kidney Health for All

The Diabetic Kidney Disease Collaborative (DKD-C) was launched in 2019 with a mission of “working together to address the urgent and unmet needs in the diagnosis and treatment of people with diabetic kidney disease.”

In addition to being the most common cause of kidney failure worldwide, DKD greatly amplifies risks of cardiovascular disease and death (1). A Strategy Conference series was launched in 2020 to determine the role of the nephrologist in diagnosing and treating DKD, to encourage nephrologists to interact proactively with primary care physicians and other specialists to ensure people with DKD receive the best care possible, and to provide education to both practitioners and patients with DKD (2–4).

To support these goals, in 2022, the DKD Steering Committee released an online learning module, “Management of Chronic Kidney Disease in People with Diabetes.” This comprehensive resource is intended for all practitioners who care for individuals with kidney diseases and diabetes. Assessment and management of hyperglycemia, hypertension, albuminuria or proteinuria, cardiovascular disease, acute kidney injury, and social determinants of health are addressed with a square focus on the patient journey (Figure 1).

View Full Size

Online chapter summary on awareness, detection, and intervention of diabetic kidney disease

Citation: Kidney News 15, 10/11

Reprinted from ASN's Management of Chronic Kidney Disease in People with Diabetes module, chapter 5 (https://epc.asn-online.org/learning_course/management-of-chronic-kidney-disease-in-people-with-diabetes/).

• Download Figure
• Download figure as PowerPoint slide

Currently, two new initiatives are underway to expand this educational effort and to promote implementation of the sodium-glucose cotransporter-2 (SGLT2) inhibitor class of agents and other guideline-directed medical therapies. These include glucagon-like peptide-1 receptor agonists and a non-steroidal mineralocorticoid antagonist for DKD. Multiple, large randomized controlled trials have now demonstrated unequivocally that SGLT2 inhibitors prevent loss of kidney function, kidney failure, heart failure and atherosclerotic cardiovascular events, and death in patients with chronic kidney disease with or without diabetes.

First, Patrick O. Gee, Sr., PhD, JLC, DKD-C Steering Committee member and longtime patient advocate, is spearheading an adaptation of the practitioner-focused online learning module into a resource designed for people with, and at risk, of kidney diseases and their support or care practitioners. A strong cadre of patient advocates, including Thelma Barber, Precious McCowan, and Virna Elly, will direct the development of content that speaks to patients' most frequent questions and concerns about kidney health, treatment options, and communication with care practitioners.

Second, Frank C. (Chip) Brosius III, MD, and Patrick H. Nachman, MD, FASN, are coordinating a two-pronged study of the cost-effectiveness of SGLT2 inhibitor treatment. The first prong will study the implementation of SGLT2 inhibitors across a cohort of patients with DKD from the Veterans Administration, and the second will focus on SGLT2 inhibitor treatment among employees with diabetes in another large U.S. health care system. These partnerships are aimed to support a sea change in nephrology toward upstream prevention and treatment, rather than late-stage reactionary care, through value-based approaches for people with, and at-risk for, kidney diseases.

The advent of breakthrough therapies for DKD is an unprecedented opportunity to save kidneys, hearts, and lives. “A world without kidney diseases…”—our ASN aspirational motto—is indeed a possibility. The DKD-C invites you to share its resources with your colleagues, patients, and communities to pursue kidney health for all. It is time to move from knowing to doing.