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Diabetes is a common cause of CKD, and both diabetes and CKD increase the risk of cardiovascular disease (CVD), the leading cause of death in individuals with CKD. This review will discuss the importance of early detection of CKD and prompt pharmacological intervention to slow CKD progression and delay the development of CVD for improving outcomes.<\/jats:p>\n                  <jats:p>Early CKD is often asymptomatic, and diagnosis usually requires laboratory testing. The combination of estimated glomerular filtration rate (eGFR) and urine albumin\u2010to\u2010creatinine ratio (UACR) measurements is used to diagnose and determine CKD severity. Guidelines recommend at least annual screening for CKD in at\u2010risk individuals. While eGFR testing rates are consistently high, rates of UACR testing remain low. This results in underdiagnosis and undertreatment of CKD, leaving many individuals at risk of CKD progression and CVD. UACR testing is an actionable component of the CKD definition.<\/jats:p>\n                  <jats:p>A four\u2010pillar treatment approach for slowing the progression of diabetic kidney disease is suggested, comprising a renin\u2013angiotensin\u2013system (RAS) inhibitor, a sodium\u2013glucose cotransporter 2 inhibitor, a glucagon\u2010like peptide 1 receptor agonist, and the nonsteroidal mineralocorticoid receptor antagonist finerenone. The combination of these agents provides a greater cardiorenal risk reduction compared with RAS inhibitors alone.<\/jats:p>\n                  <jats:p>Early detection of CKD and prompt intervention with guideline\u2010directed medical therapy are crucial for reducing CVD risk in individuals with CKD and diabetes. Evidence from ongoing studies will advance our understanding of optimal therapy in this population.<\/jats:p>","DOI":"10.1111\/joim.20050","type":"journal-article","created":{"date-parts":[[2024,12,31]],"date-time":"2024-12-31T12:35:39Z","timestamp":1735648539000},"page":"460-478","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Treatment strategies to reduce cardiovascular risk in persons with chronic kidney disease and Type 2 diabetes"],"prefix":"10.1111","volume":"297","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7456-1570","authenticated-orcid":false,"given":"Faiez","family":"Zannad","sequence":"first","affiliation":[{"name":"Inserm, Centre d'Investigation Clinique Plurith\u00e9matique 1433, U1116, CHRU de Nancy F\u2010CRIN INI\u2010CRCT Universit\u00e9 de Lorraine  Nancy France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren K.","family":"McGuire","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Internal Medicine The University of Texas Southwestern Medical Center and Parkland Health  Dallas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9805-9523","authenticated-orcid":false,"given":"Alberto","family":"Ortiz","sequence":"additional","affiliation":[{"name":"RICORS2040  Madrid Spain"},{"name":"Nephrology and Hypertension Department Hospital IIS\u2010Fundaci\u00f3n Jim\u00e9nez D\u00edaz UAM  Madrid Spain"},{"name":"Medicine Department Medicine Faculty, Universidad Autonoma de Madrid  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,31]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2019.07.012"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30045-3"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31694-5"},{"issue":"4","key":"e_1_2_7_5_1","doi-asserted-by":"crossref","first-page":"S117","DOI":"10.1016\/j.kint.2023.10.018","article-title":"KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease","volume":"105","author":"Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group","year":"2024","journal-title":"Kidney Int."},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfac257"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab484"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.17002"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfaa235"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfae053"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2369-14-46"},{"key":"e_1_2_7_12_1","volume-title":"Chronic kidney disease in the United States","author":"Centers for Disease Control and Prevention","year":"2023"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.2337\/db20211-13"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.2337\/cd23-0063"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.050686"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40697-014-0033-6"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.26230"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc21-0723"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.121.17323"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc20-2715"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11255-023-03516-1"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-021-02147-6"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.0000000000000361"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41581-023-00789-8"},{"key":"e_1_2_7_25_1","unstructured":"American College of Cardiology.ASCVD risk estimator plus.Washington:American College of Cardiology;2018. 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