2) This activity is accredited for #physicians #physicianassistants #nurses #NPs #pharmacists. Credit from past programs: https://t.co/Yr5ymo7iR0 and https://t.co/cDec9QAxcH. Faculty disclosures are available at https://t.co/HgNk2ajJBC. Your expert author is @RpratleyMD pic.twitter.com/shqOqlwVEI
— cardio-met (@cardiomet_CE) January 19, 2022
4) The chronic complications of diabetes drive morbidity, mortality, and costs. pic.twitter.com/HLJbfkSFkB
— cardio-met (@cardiomet_CE) January 19, 2022
6) Physical exam: Ht: 5’4” Wt 180 lbs BMI 30.9 kg/m2 BP 130/84 mmHg
— cardio-met (@cardiomet_CE) January 19, 2022
Labs: FPG 112 mg/dL, HbA1c 7.6%
Serum creatinine 1.5 mg/dL
Random urine albumin/creatinine ratio 40 mg/dL
8) Let’s start by looking at her estimated glomerular filtration rate (#eGFR). Most labs are now providing a calculated eGFR. Various formulas have been used over the years. The latest recommendations from @nkf are to use the CKD-EPI creatinine equation without race
— cardio-met (@cardiomet_CE) January 19, 2022
10) And her calculated estimated glomerular filtration rate (#eGFR) is 43 mL/min. pic.twitter.com/f5WXrZDDgo
— cardio-met (@cardiomet_CE) January 19, 2022
12) Both albuminuria & reduced GFR are associated with increased risk of renal events. ADVANCE provided observational analyses examining the association between albuminuria & GFR at baseline or during follow-up & risk for CV events & renal events in T2D. https://t.co/QdCTJZu3Xo pic.twitter.com/yAnS5qSuWF
— cardio-met (@cardiomet_CE) January 19, 2022
14) And this in turn helps us classify the risk for our patient (see tweets #5-6): pic.twitter.com/zmAE3JGU7D
— cardio-met (@cardiomet_CE) January 19, 2022
16) Mark your response and return TOMORROW for the correct answer and more #accredited education!@KIReports @NIDDKgov @StefaniaArciell @ErinMichos @KatherineTuttl8 @polska_md @nephondemand @dguerrot
— cardio-met (@cardiomet_CE) January 19, 2022
And here’s a good #patienteducation video for #DKD: https://t.co/R5PH0Qmb1W
18) Yesterday's poll? If you didn't vote yet, go back to tweet #15, and mark your answer. pic.twitter.com/JCTprf7MqK
— cardio-met (@cardiomet_CE) January 20, 2022
20) Diabetes is in fact the leading cause of end-stage kidney/renal disease (#ESKD #ESRD). pic.twitter.com/NoXo5yFbhK
— cardio-met (@cardiomet_CE) January 20, 2022
22) And it's not just #RRT: #DKD impacts so many aspects of #QoL. Of the long-term complications of #diabetes, #CKD imposes the highest burden, both in terms of financial cost and the effects on daily life. The presence and severity of CKD identify . . . pic.twitter.com/XHxN3lhIIy
— cardio-met (@cardiomet_CE) January 20, 2022
24) Indeed, those patients with DKD who progress to #ESKD have a higher 5-year mortality than do those with many types of cancer. The average lifespan shortening of patients with early DKS is in fact how many years?
— cardio-met (@cardiomet_CE) January 20, 2022
26) So here's the follow-up question: what accounts for the decreased lifespan in patients with diabetes? Answer the poll below:
— cardio-met (@cardiomet_CE) January 20, 2022
28) Welcome back! I am @RpratleyMD and you're almost done with your 0.5h CE/#CME foundational program on #CKD in #T2D: #DKD. Follow this thread to conclusion for your credit. @AliceYYCheng @yhandelsmanmd @OGMustafa @NohaAshy @kamleshkhunti @DanielJDrucker @P_Rossing
— cardio-met (@cardiomet_CE) January 21, 2022
30) In particular, there is interplay between #heartfailure and #CKD . . . but the same can be said of multiple etiologies of #CV pathology, such as #hypertension, atherogenic dyslipidemia, endothelial dysfunction, hypercoagulability, chronic inflammation, & oxidative stress pic.twitter.com/URFWd9GSkm
— cardio-met (@cardiomet_CE) January 21, 2022
32) And it's worth repeating . . . this pandemic is spreading too: pic.twitter.com/IyumFYZiro
— cardio-met (@cardiomet_CE) January 21, 2022
34) So how do we screen? Here's a sneak peek at an upcoming #accredited #tweetorial in this foundational series: pic.twitter.com/eNs0Dcdhwk
— cardio-met (@cardiomet_CE) January 21, 2022
36) (cont)
— cardio-met (@cardiomet_CE) January 21, 2022
The minority of patients with DKD progress to ESRD
Patients with diabetes on dialysis have a very poor prognosis
Patients with diabetes should be screened at least annually for DKD with #eGFR and random urine albumin to creatinine ratio (#UACR)
37) And now you have made it! Free CE/#CME! #Physicians #pharmacists #nurses #PAs: go to https://t.co/9Pt3AwGtXQ and claim your credit! I am @RPratleyMD. Follow @cardiomet_CE (and @ckd_ce) for more #tweetorials! #medtwittter #cardiotwitter #diabetickidneydisease #nephtwitter pic.twitter.com/WNt2oKP7qD
— cardio-met (@cardiomet_CE) January 21, 2022