Bridging the Disconnect: From Diagnosis to Treatment in Cardio-Renal-Metabolic Syndrome

Welcome back to another AJMC Insights series. In this episode titled, ‘Bridging the Disconnect: From Diagnosis to Treatment in Cardio-Renal-Metabolic Syndrome’, Ian Neeland led the conversation about the following questions:

In people with type 2 diabetes, CKD prevalence is high (~40.7%), yet over half may lack a documented CKD diagnosis, underlining detection gaps. What strategies can bridge the disconnect between diagnosis and treatment initiation?

Obesity (BMI ≥30) affects over 30% of U.S. adults and is a major driver of insulin resistance, type 2 diabetes, CKD progression, and MASLD. How do access barriers, including coverage and awareness, contribute to delays in treatment in patients with obesity?

Ian Neeland highlighted the critical need for increased screening utilizing both estimated glomerular filtration rate (eGFR) and urine albumin-creatinine ratio (UACR) to identify chronic kidney disease (CKD) early. He emphasized that addressing obesity requires a multidisciplinary approach beyond simple counseling, focusing on systematic behavioral changes and the utilization of newer incretin-based weight loss medications. Additionally, overcoming barriers such as high costs and lack of insurance coverage is essential to improving patient access to these life-altering treatments.

Throughout the conversation, the expert provided a comprehensive reflection on the field and the factors that may shape how clinicians approach care moving forward.

In the next episode, ‘Foundational Therapy Approaches to Mitigate Long-Term CRM Complications’, the panelist continue their discussion on cardio-renal-metabolic (CRM) syndrome and highlight unmet needs in metabolic dysfunction-associated steatotic liver disease (MASLD) and the role of lifestyle and guideline-directed medical therapy (GDMT).