From Insight to Action: Tackling the MASLD and MASH Epidemic-Module 5: Holistic Management of the Cardio-Kidney-Metabolic Spectrum

Video Transcription

Video Summary

In Module 5, Dr. Javier Morales and Dr. Aman Rajpal discuss the holistic management of the cardiokidney metabolic (CKM) spectrum, emphasizing its interconnected nature involving cardiovascular disease, chronic kidney disease, type 2 diabetes, obesity, and metabolic liver disease (MASH). They outline screening protocols for children, adolescents, and adults to identify early risk factors like obesity, hypertension, lipid abnormalities, and liver dysfunction. The presenters highlight a patient case demonstrating complexity with multi-organ involvement, advocating for a comprehensive, patient-centered approach rather than glucocentric treatment alone. They critique older therapies, such as sulfonylureas, due to risks like hypoglycemia and weight gain, and stress the importance of intensive lipid control and renal monitoring to reduce cardiovascular and kidney risks. Recent advances include the use of GLP-1 receptor agonists, SGLT2 inhibitors, and pioglitazone, which improve glycemic control, reduce cardiovascular events, delay CKD progression, and benefit fatty liver disease. Combination therapy leveraging complementary mechanisms can mitigate side effects while maximizing therapeutic effects. The speakers advocate a multidisciplinary team-based care model integrating lifestyle modification, pharmacotherapy, and social support to improve outcomes. Ultimately, early identification and a holistic, multifaceted treatment strategy are essential to managing CKM syndrome and improving patients' long-term health and quality of life.

Keywords

cardiokidney metabolic spectrum

cardiovascular disease

chronic kidney disease

type 2 diabetes

obesity

metabolic liver disease

multidisciplinary care