ReviewThe Journal of clinical endocrinology and metabolism2026
Combination treatment for the management of chronic kidney disease and type 2 diabetes: a review and practical guidance.
Review in The Journal of clinical endocrinology and metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Diabetic kidney disease within the framework of cardio-kidney-metabolic health: a paradigm shift.Frontiers in pharmacology · 2026Review
Corrections and comments
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Authors and funding
16 authors.
Funding
Abstract
contextRenin-angiotensin system inhibitors (RASi), sodium glucose cotransporter-2 inhibitors (SGLT2i), non-steroidal mineralocorticoid receptor antagonists (nsMRA), and glucagon-like peptide-1 receptor agonists (GLP-1RA) are key components of guideline-directed medical treatments (GDMT) for chronic kidney disease (CKD) with type 2 diabetes (T2D). However, the combined use of these medications remains uncommon in clinical practice, in part, due to the absence of specific guidance on implementing combination treatment. Herein, we aim to (1) summarize the evidence supporting combination GDMT in CKD with T2D, (2) propose a practical algorithm to guide the accelerated implementation of quadruple treatment, and (3) discuss strategies to improve the uptake of combination treatment. EVIDENCE ACQUISITION: We searched PubMed from inception to present for English-speaking studies using the search terms: "renin-angiotensin system inhibitor," "sodium glucose cotransporter-2 inhibitor," "nonsteroidal mineralocorticoid receptor antagonist," "glucagon-like peptide-1 receptor agonist," and "diabetes." We focused on clinical guidelines, randomized controlled trials (RCTs), and, if necessary, large observational studies. EVIDENCE SYNTHESIS: SGLT2i, nsMRA, and GLP-1RA confer early cardiovascular and kidney protection through independent mechanisms, allowing them to be combined. RCTs support the use of each agent on top of "standard care," and multiple clinical guidelines endorse combination treatment. However, the optimal order and timing for medication initiation and the approach to managing treatment-related side effects remain uncertain, thereby limiting the uptake of combination treatment.
conclusionCurrent evidence supports the use of combination GDMT in CKD with T2D. We propose a combination treatment algorithm that may combat clinical inertia and achieve greater cardiorenal risk reduction in high-risk patients with CKD and T2D.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.