Kidney & Metabolic Renal Health
Chronic kidney disease (CKD) is one of the most serious consequences of diabetes, hypertension and obesity. It greatly increases cardiovascular risk, yet is frequently detected late.
Kidneys, heart and metabolism are tightly linked.
Diabetes and hypertension are the leading causes of CKD. Simple tests — estimated glomerular filtration rate and urine albumin-to-creatinine ratio — can identify kidney disease early, but are not performed consistently.
Therapeutic advances, including SGLT2 inhibitors, non-steroidal mineralocorticoid receptor antagonists, RAS blockade and incretin-based therapies, now make it possible to slow kidney decline and reduce cardiovascular events.
IMACH promotes early detection, risk-based management and coordinated care between nephrology, metabolic medicine, cardiology and primary care.
Key areas of scientific focus
Detection & staging
- Screening with eGFR and UACR
- CKD staging and risk prediction
- Diabetic kidney disease
- Hypertensive and obesity-related kidney disease
- Acute kidney injury in metabolic patients
- CKD in older adults
Treatment
- RAS blockade
- SGLT2 inhibitors for kidney protection
- Non-steroidal MRAs
- Incretin-based therapies and the kidney
- Blood pressure and glucose targets in CKD
- Drug dosing and safety in reduced kidney function
Complications & care
- Anaemia, bone and mineral disorders
- Cardiovascular disease in CKD
- Nutrition in kidney disease
- Preparation for renal replacement therapy
- Referral to nephrology
- Patient education and self-management
Clinical challenges we address
Late diagnosis
Many patients reach advanced CKD without having had urine albumin tested.
Under-use of therapy
Proven kidney-protective medicines are under-prescribed.
Medication safety
Dosing adjustments are frequently overlooked.
High cardiovascular risk
Most people with CKD die of cardiovascular disease before kidney failure.
Fragmented care
Kidney, heart and diabetes care are often provided separately.
Translating evidence into everyday care
IMACH focuses on making kidney screening routine, applying organ-protective therapy early and ensuring safe prescribing.
Kidney care pathway:
| Care stage | Focus for clinicians |
|---|---|
| Screen | eGFR and UACR at least annually in diabetes and hypertension. |
| Stage & stratify | CKD stage and risk of progression. |
| Protect | Blood pressure control, RAS blockade, SGLT2i and other agents as indicated. |
| Manage complications | Anaemia, bone health, cardiovascular risk, nutrition. |
| Refer | Nephrology referral at defined thresholds. |
IMACH programmes in this area
CKD in metabolic practice
Screening and management for non-nephrologists.
Cardiorenal-metabolic symposia
Joint cardiology–nephrology–endocrinology programmes.
Safe prescribing modules
Drug dosing in reduced kidney function.
Renal nutrition workshops
Dietary management in CKD.
Case conferences
Complex diabetic kidney disease.
Who this area brings together
Kidney protection requires shared responsibility across nephrology, metabolic medicine, cardiology, primary care and pharmacy.
Questions we explore
- How can UACR testing become routine?
- How should multiple kidney-protective therapies be combined?
- When should patients be referred to nephrology?
- How should cardiovascular risk be managed in CKD?
Frequently asked questions
Why focus on urine albumin?
Albuminuria is often the earliest sign of kidney damage and strongly predicts both kidney and cardiovascular outcomes.
Is dialysis covered?
IMACH focuses on prevention and early-to-moderate CKD, including preparation for renal replacement therapy.
This page is intended for healthcare professionals and is educational in nature. It does not constitute medical advice or treatment recommendations for individual patients. Clinical decisions should follow current guidelines, local regulations and individual patient assessment.
Contribute to kidney–metabolic care at IMACH.
Join as a member, faculty or research collaborator in this therapy area.