The Curbsiders Internal Medicine Podcast #454 Kidney Boy on Managing Diabetes and Hypertension in CKD
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Sep 23, 2024 
Join nephrologist Joel Topf, also known as Kidney Boy, as he shares his expertise on managing diabetes and hypertension in chronic kidney disease. He discusses key strategies for controlling blood pressure, the importance of timely referrals, and the latest updates in CKD management guidelines. Delve into innovative treatments like SGLT2 inhibitors and ARNI drugs, and explore the significance of personalized care for elderly patients. Topf also champions the use of AI technology to enhance clinical documentation, making patient care more efficient.
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Classifying CKD
- Classify chronic kidney disease (CKD) by considering etiology, GFR, and albuminuria.
- Utilize the kidney failure risk equation to predict patient outcomes and discuss dialysis options.
Using Cystatin C
- Consider cystatin C for patients with CKD 3A to recategorize them if needed.
- Cystatin C is a better marker than creatinine, especially for athletes, the elderly, and those with varying muscle mass.
Blood Pressure Management in CKD
- Switch hydrochlorothiazide to chlorthalidone, losartan to a longer-acting ARB (like telmisartan), and add a calcium channel blocker.
- These changes can improve blood pressure control in CKD patients.