The Curbsiders Internal Medicine Podcast #384 Updates in Chronic Kidney Disease with Dr. Joel Topf
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Mar 6, 2023 
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Managing CKD Risk
- Prioritize albuminuria as a modifiable risk factor in CKD patients.
- Use the kidney failure risk equation to communicate risk effectively.
Metformin and Lactic Acidosis
- Metformin-associated lactic acidosis typically occurs in patients with AKI, not stable CKD.
- It's not the slow progression past a GFR threshold that causes the problem.
SGLT2 Inhibitor Initiation
- Avoid starting SGLT2 inhibitors in patients with poorly controlled diabetes (A1C > 10%).
- These patients can experience significant osmotic diuresis and other adverse effects.