Sweet Urine; good times never seemed so good!

The Rest is Kidneys

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The Rest is Kidneys podcast series is brought to you by Imperial College Healthcare NHS Trust and North West London Integrated Care Board (NWL NHS)
In this episode, Jeremy Levy and Andrew Frankel discuss the game-changing role of SGLT2 inhibitors in treating chronic kidney disease (CKD). These drugs, initially developed for diabetes, have shown remarkable benefits in slowing CKD progression, reducing cardiovascular risks, and delaying dialysis. They cover the key patient groups, prescribing tips, and how to use these medications safely and effectively.
Top Three Takeaways:
1. Broad Benefits Beyond Diabetes:
SGLT2 inhibitors significantly slow CKD progression, reduce cardiovascular risks, and delay the need for dialysis, benefiting patients with or without diabetes.
2. Who Should Get Them:

• Heart failure patients.
• CKD patients with or without diabetes and/or albuminuria.
• Patients with GFR between 20-45, regardless of urine albumin levels.

3. Safety and Usage Tips:

• Avoid type 1 diabetes or "type 1-like" patients.
• Manage minor side effects (e.g., fungal infections) and provide "Sick Day Guidance" to minimise risks like ketoacidosis.

This episode provides practical insights and actionable advice for clinicians managing CKD patients.
Resource Links:
NICE GUIDELINES [NG203] chronic kidney disease: assessment and management Overview | Chronic kidney disease: assessment and management | Guidance | NICE

Northwest London CKD guidelines for primary care Chronic kidney disease (nwlondonicb.nhs.uk)

The purpose of this podcast is to inform and educate health care professionals working in the primary care and community setting. The content is evidence based and consistent with NICE guidelines and North West Guidelines available at the time of publication.

The content of this podcast does not constitute medical advice and it is not intended to function as a substitute for a healthcare practitioner’s judgement.
Produced by award-winning media and marketing specialist Heather Pownall of Heather's Media Hub

Разделы

1. Sweet Urine; good times never seemed so good! (00:00:00)

2. What are the cardiac and renal benefits of SGLT2 inhibitors, and why are we using them beyond diabetes? (00:01:27)

3. Which patients with chronic kidney disease would benefit most from adding SGLT2 inhibitors? (00:04:28)

4. So have you any advice about the most effective way of starting these drugs? (00:07:16)

5. The number of patients that shouldn't use SGLT2 inhibitors is very small isn't it? (00:09:57)

6. What about the diuresis? (00:11:45)

7. There's been some overstatement about the risk of urinary tract or fungal infections due to sugary urine. Can you explain this? (00:12:38)