Kenneth Mahaffey, MD: The Relationship Between Cardiology, Endocrinology, and Nephrology

Canagliflozin could help serve a patient population with type 2 diabetes at a high risk of renal or cardiovascular events.

During the American Society of Nephrology (ASN) Kidney Week in Washington, D.C., Kenneth Mahaffey, MD, professor of cardiovascular medicine at the Stanford University Medical Center, explained in an interview with MD Magazine® the success of canagliflozin in the CREDENCE study and what needs to happen in the future to better serve this patient population.

MD Magazine: What do you believe the impact of the CREDENCE study will be?

Mahaffey: Well the CREDENCE trial of 4401 participants showed that canaglflozin on top of standard care in patients with type 2 diabetes and diabetic kidney disease significantly reduced renal outcomes including a composite of end-stage kidney disease, doubling of serum creatinine, renal or cardiovascular death.

It also showed that there was a significant reduction in cardiovascular death or hospitalization for heart failure as well as cardiovascular death, MI and stroke.

Given these very important and robust findings, I believe that canagliflozin is a very important therapy for our physicians to consider when they're seeing patients with type 2 diabetes and diabetic kidney disease.

MD Magazine: Has the relationship between cardiology, nephrology, and endocrinology been overlooked in the past?

Mahaffey: Unfortunately, I think that both in the research domains, as well as our clinical enterprises, we treat patients with type 2 diabetes in very siloed organizations.

You're exactly right, we have cardiologists seeing these patients, we have nephrologists seeing these patients, we have endocrinologist seeing these patients, and our primary care colleagues.

I think it's important now that we're seeing this biological link between diabetes and it's complications in the kidney domain and the cardiovascular domain.

Now we have therapies like canaglflozin that really provide the trifecta of improving the metabolic derangements that the endocrinologist are very careful to follow, the renal outcomes that the nephrologist follow, the cardiovascular outcomes that the cardiologists follow and all of them are important to our primary care colleagues.

So, it's very important that we think about this disease as a disease that needs teams to come together to treat it most effectively.