Evidence mapPaperPMID 40971126Full record

ReviewDiabetes therapy : research, treatment and education of diabetes and related disorders2025

Pillar Risk-Based Treatment for Chronic Kidney Disease in People With Type 2 Diabetes: A Narrative Review.

Alice Y Y Cheng, Amy Mottl, Melissa Magwire

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In one paragraph

Review in Diabetes therapy : research, treatment and education of diabetes and related disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

3 authors.

Alice Y Y ChengTrillium Health Partners, Toronto, ON, Canada. alice.cheng@unityhealth.to.
Amy MottlThe University of North Carolina Kidney Center, Chapel Hill, NC, USA.
Melissa MagwireCardiometabolic Center Alliance, Kansas City, MO, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Chronic kidney disease continues to be a significant burden for people living with type 2 diabetes, despite the available guideline-directed treatment options. Traditionally, a stepwise approach has been implemented for the management of chronic kidney disease and type 2 diabetes, which involves the linear sequential initiation of one therapy after the other on the basis of an individual's treatment outcomes. However, this approach is not beneficial for all individuals, as it can lead to treatment inertia and subsequent disease progression. Therefore, primary care practitioners should consider implementing a more proactive treatment strategy to optimize care. The pillar risk-based approach is an emerging concept with goals of glucose control and blood pressure control as well as comprising simultaneous or rapid sequential initiation of multiple therapies, such as renin-angiotensin system inhibitors (RASi), sodium-glucose cotransporter 2 inhibitors, a nonsteroidal mineralocorticoid receptor antagonist (finerenone), and glucagon-like peptide-1 receptor agonists, which target the different hemodynamic, metabolic, and fibrotic/inflammatory pathways involved in chronic kidney disease and type 2 diabetes. This approach enables earlier chronic kidney disease risk reduction, and the recently published CONFIDENCE trial reported tolerability and efficacy of simultaneous initiation of two of these therapies (finerenone and empagliflozin) in those already receiving RASi. This review article provides primary care practitioners with practical considerations, discussing current guideline-directed treatment options for chronic kidney disease in people with type 2 diabetes in the context of a historical stepwise approach versus the new patient-centric pillar risk-based approach.

Indexed as

Chronic kidney diseaseGlucagon-like peptide-1 receptor agonistGuideline-directed treatmentMineralocorticoid receptor antagonistRenin–angiotensin system inhibitorSodium–glucose cotransporter 2 inhibitorType 2 diabetes

Identifiers

PMID40971126
PMCPMC12579093

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.