Optimizing Cardio-Kidney Care With Multilevel Coordination: Roy Mathew, MD

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Improving clinical outcomes for patients navigating the complex intersection of chronic kidney disease (CKD) and cardiovascular (CV) risk requires a shift from traditional siloed treatment toward more holistic, multidisciplinary delivery models, said Roy O. Mathew, MD, associate professor of medicine at the Loma Linda VA Health Care System. He presented on kidney health as a determinant of cardiovascular risk during the 2025 American Heart Association (AHA) Scientific Sessions, held in New Orleans, Louisiana, November 7-10, 2025.

The current landscape of integrated care is supported by promising, yet limited, data. While multidisciplinary care models have shown success in single-center settings, there need to be more large-scale, multisystem trials to validate these approaches against usual care, Mathews noted. The challenge lies not only in the clinical delivery but also in the “silent” nature of these diseases, which often lack the acute symptoms that drive patients to follow complex medication regimens.

Mathew emphasized that the “human element” of care—specifically patient engagement and the incorporation of community resources—is the missing link in ensuring long-term adherence to new therapeutics. As the health care industry moves toward a more digitized future, the integration of technology and lifestyle management will become central to population health strategies. Often patients are looking for alternatives to therapeutics, like lifestyle management.

“I think they want every opportunity to make themselves better,” he said. “They know that the problem exists; we have to figure out how better to engage our patients. Once we engage them, I think eventually we can show them that these therapeutics work.”

Looking ahead, the next generation of care delivery will likely be defined by a shift toward self-advocacy and the thoughtful application of artificial intelligence. By leveraging technology to provide personalized, actionable information, health systems can better support patients in managing asymptomatic risks before they escalate into high-cost, acute events.