For your adult patients with CKD associated with T2D
Your help is needed at every stage of their disease4,10,13
T2D for 8 years, has CKD, and is taking multiple standard-of-care medications*
eGFR declined from 71 to
67 mL/min/1.73 m2 in the past year
Microalbuminuria: 150 mg/g†
Serum potassium: 3.8 mEq/L
SBP: 136 mmHg
DBP: 84 mmHg
Karla’s current antihypertensive medications: maximum ACEi, CCB, and thiazide diuretic
In adult patients with CKD associated with T2D
Even with earlier-stage CKD, Karla faces an increased risk of CV mortality
Together, eGFR and urinary protein (measured by UACR) show what could lie ahead for your patients10
Colors reflect the ranking of adjusted relative risk from a categorical meta-analysis. Rank numbers 1 to 8=green; 9 to 14=yellow; 15 to 21=orange; 22 to 28=red.
Adapted with permission from KDIGO. Levey AS, de Jong PE, Coresh J, et al. Chapter 2: Definition, identification, and prediction of CKD progression. Kidney Int Suppl. 2013;3(1):63-72. Accessed November 21, 2023. https://www.kisupplements.org/article/S2157-1716(15)31102-3/fulltext
ACR=albumin-to-creatinine ratio; CKD=chronic kidney disease; CV=cardiovascular; eGFR=estimated glomerular filtration rate; KDIGO=Kidney Disease: Improving Global Outcomes; T2D=type 2 diabetes; UACR=urine albumin-to-creatinine ratio.
T2D for 10 years, has CKD, and is taking multiple standard-of-care medications*
eGFR declined from 62 to
58 mL/min/1.73 m2 in the past year
Microalbuminuria: 220 mg/g†
Serum potassium: 4.2 mEq/L
SBP: 145 mmHg
DBP: 85 mmHg
Karla’s current antihypertensive medications: maximum ACEi, CCB, and thiazide diuretic
In adult patients with CKD associated with T2D
Karla faces a high risk for CV mortality
Together, eGFR and urinary protein (measured by UACR) show what could lie ahead for your patients10
Colors reflect the ranking of adjusted relative risk from a categorical meta-analysis. Rank numbers 1 to 8=green; 9 to 14=yellow; 15 to 21=orange; 22 to 28=red.
Adapted with permission from KDIGO. Levey AS, de Jong PE, Coresh J, et al. Chapter 2: Definition, identification, and prediction of CKD progression. Kidney Int Suppl. 2013;3(1):63-72. Accessed November 21, 2023. https://www.kisupplements.org/article/S2157-1716(15)31102-3/fulltext
ACR=albumin-to-creatinine ratio; CKD=chronic kidney disease; CV=cardiovascular; eGFR=estimated glomerular filtration rate; KDIGO=Kidney Disease: Improving Global Outcomes; T2D=type 2 diabetes; UACR=urine albumin-to-creatinine ratio.
T2D for 12 years, has CKD, and is taking multiple standard-of-care medications*
eGFR declined from 50 to
44 mL/min/1.73 m2 in the past year
Macroalbuminuria: 360 mg/g†
Serum potassium: 4.4 mEq/L
SBP: 149 mmHg
DBP: 90 mmHg
Karla’s current antihypertensive medications: maximum ACEi, CCB, thiazide diuretic, and a beta blocker
In adult patients with CKD associated with T2D
Karla now faces a very high risk of CV mortality. What’s your move?
Together, eGFR and urinary protein (measured by UACR) show what could lie ahead for your patients10
Colors reflect the ranking of adjusted relative risk from a categorical meta-analysis. Rank numbers 1 to 8=green; 9 to 14=yellow; 15 to 21=orange; 22 to 28=red.
Adapted with permission from KDIGO. Levey AS, de Jong PE, Coresh J, et al. Chapter 2: Definition, identification, and prediction of CKD progression. Kidney Int Suppl. 2013;3(1):63-72. Accessed November 21, 2023. https://www.kisupplements.org/article/S2157-1716(15)31102-3/fulltext
ACR=albumin-to-creatinine ratio; CKD=chronic kidney disease; CV=cardiovascular; eGFR=estimated glomerular filtration rate; KDIGO=Kidney Disease: Improving Global Outcomes; T2D=type 2 diabetes; UACR=urine albumin-to-creatinine ratio.
You can act now to help your CKD patients who face CV and renal risks
For your adult patients with CKD associated with T2D
Elevated albuminuria increases their risk for cardiorenal events17
Identify your patients with early-stage CKD associated with T2D
Dr Javier Morales explains the consequences of CKD associated with T2D, and the crucial need to diagnose and treat patients earlier in their disease progression.
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*The FIDELIO-DKD and FIGARO-DKD trials were randomized, double-blind, placebo-controlled, multicenter trials of adult patients with CKD associated with T2D. In the FIDELIO-DKD trial, approximately 97% of patients were on an antidiabetic medication (insulin [64.1%], biguanides [44%], GLP-1 receptor agonists [7%], and/or SGLT2 inhibitors [5%]). Background therapies were similar in the FIGARO-DKD trial.13
†Microalbuminuria can be defined as “moderately increased” with a UACR of 30-300 mg/g.10
ACEi=angiotensin-converting enzyme inhibitor; CCB=calcium channel blocker; CKD=chronic kidney disease; CV=cardiovascular; DBP=diastolic blood pressure; eGFR=estimated glomerular filtration rate; GLP-1=glucagon-like peptide-1; SBP=systolic blood pressure; SGLT2=sodium-glucose cotransporter 2; T2D=type 2 diabetes; UACR=urine albumin-to-creatinine ratio.
INDICATION:
KERENDIA is indicated to reduce the risk of sustained eGFR decline, end-stage kidney disease, cardiovascular death, non-fatal myocardial infarction, and hospitalization for heart failure in adult patients with chronic kidney disease (CKD) associated with type 2 diabetes (T2D)
IMPORTANT SAFETY INFORMATION
CONTRAINDICATIONS:
- Concomitant use with strong CYP3A4 inhibitors
- Patients with adrenal insufficiency
WARNINGS AND PRECAUTIONS:
Hyperkalemia: KERENDIA can cause hyperkalemia. The risk for developing hyperkalemia increases with decreasing kidney function and is greater in patients with higher baseline potassium levels or other risk factors for hyperkalemia. Measure serum potassium and eGFR in all patients before initiation of treatment with KERENDIA and dose accordingly. Do not initiate KERENDIA if serum potassium is >5.0 mEq/L
Measure serum potassium periodically during treatment with KERENDIA and adjust dose accordingly. More frequent monitoring may be necessary for patients at risk for hyperkalemia, including those on concomitant medications that impair potassium excretion or increase serum potassium
MOST COMMON ADVERSE REACTIONS:
- From the pooled data of 2 placebo-controlled studies, the adverse reactions reported in ≥1% of patients on KERENDIA and more frequently than placebo were hyperkalemia (14% vs 6.9%), hypotension (4.6% vs 3.9%), and hyponatremia (1.3% vs 0.7%)
DRUG INTERACTIONS:
- Strong CYP3A4 Inhibitors: Concomitant use of KERENDIA with strong CYP3A4 inhibitors is contraindicated. Avoid concomitant intake of grapefruit or grapefruit juice
- Moderate and Weak CYP3A4 Inhibitors: Monitor serum potassium during drug initiation or dosage adjustment of either KERENDIA or the moderate or weak CYP3A4 inhibitor and adjust KERENDIA dosage as appropriate
- Strong and Moderate CYP3A4 Inducers: Avoid concomitant use of KERENDIA with strong or moderate CYP3A4 inducers
USE IN SPECIFIC POPULATIONS:
- Lactation: Avoid breastfeeding during treatment with KERENDIA and for 1 day after treatment
- Hepatic Impairment: Avoid use of KERENDIA in patients with severe hepatic impairment (Child Pugh C) and consider additional serum potassium monitoring with moderate hepatic impairment (Child Pugh B)
Please read the Prescribing Information for KERENDIA.
