Rapid Clinical Updates: Cardio-Renal-Metabolic Disease and Care Models for Hospital Medicine-Slides

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The Rapid Clinical Updates on Cardio-Renal-Metabolic (CRM) Disease and Care Models for Hospital Medicine featured expert speakers Drs. Muthiah Vaduganathan, Ebrahim Barkoudah, and Lily Ackermann, highlighting advances in the treatment and hospital care approaches for patients with intertwined cardiovascular, renal, and metabolic conditions.<br /><br />Key treatment pillars for cardiometabolic kidney disease include four medication classes: renin-angiotensin system (RAS) inhibitors (ACE inhibitors and ARBs), sodium-glucose cotransporter-2 (SGLT2) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists, and non-steroidal mineralocorticoid receptor antagonists (nsMRAs). Landmark trials have transformed SGLT2 inhibitors from solely antihyperglycemic agents into foundational therapies providing cardiorenal protection across diabetes and chronic kidney disease (CKD) spectrums. Practical frameworks from studies like CONFIDENCE allow clinicians to optimize combination therapies of SGLT2 inhibitors and MRAs, especially in moderate to advanced CKD patients. STRONG-HF trial data inform initiation and sequencing of evidence-based cardiorenal therapies during hospitalization, emphasizing the need for monitoring protocols to ensure safe clinical implementation.<br /><br />Critical hospital medicine strategies discussed included care transitions and discharge planning protocols—medication bridging, standardized discharge arrangements, patient education on adherence and lifestyle, and coordinated follow-up with outpatient providers. Development of clinical pathways using electronic health record (EHR) integrations facilitates systematic risk screening and decision support for medication management, while quality improvement measures track CKM-specific outcomes. Addressing social determinants of health through screening and community resource integration was emphasized.<br /><br />Sustainable, patient-centered CRM care models require organizational transformations, provider education, technology adoption, and policy backing. Value-based care models focusing on outcomes rather than service volume may promote broader adoption in hospital settings, ultimately improving clinical results for this high-risk patient population.

Keywords

Cardio-Renal-Metabolic Disease

Hospital Medicine

SGLT2 Inhibitors

Renin-Angiotensin System Inhibitors

GLP-1 Receptor Agonists

Non-Steroidal Mineralocorticoid Receptor Antagonists

CKD Management

Care Transitions

Electronic Health Record Integration

Value-Based Care Models