Bridging gaps in chronic kidney disease management: insights from clinicians on real-world practices
DOI:
https://doi.org/10.18203/2349-3259.ijct20253332Keywords:
Diabetic nephropathy, CKD management, SGLT2 Inhibitors, Finerenone, GLP-1 RAAbstract
Background: Chronic kidney disease (CKD) is frequently underdiagnosed in early stages, especially in India, due to its asymptomatic onset, limited diagnostics, and delayed referrals. This study aimed to assess real-world CKD management practices and gaps among Indian clinicians.
Methods: A structured survey of 40 clinicians across 11 cities in India captured data on CKD staging, treatment preferences, and complication(s) management.
Results: Early-stage CKD (3a/3b) was most commonly diagnosed stage of CKD. Moreover, diabetic nephropathy was prevalent in 55% cases, followed by hypertensive nephropathy in 35% cases and other risk factors in 10% cases. Sodium-glucose cotransporter 2 inhibitors, nonsteroidal mineralocorticoid receptor antagonists (finerenone), and glucagon-like peptide-1 receptor agonists were preferred in diabetic CKD. Metformin was often de-escalated at Stage 3b. For complications, sodium polystyrene sulfonate and darbepoetin alfa were commonly used for hyperkalaemia and anaemia, respectively. Budesonide emerged as a key choice in IgA nephropathy.
Conclusions: Despite increasing use of evidence-based therapies, significant gaps remain in early diagnosis and uniform management, highlighting the need for improved awareness and access to newer agents to optimize CKD care.
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References
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