Loading Curie Briefs...
Getting the latest healthcare news for you
Getting the latest healthcare news for you
When it comes to treating diabetes-related chronic kidney disease (CKD), should doctors start multiple drugs at once or add them one by one? Experts debated both approaches at the ADA 2026 Scientific Sessions — and while they disagreed on the method, they agreed on the goal: get patients on combination therapy quickly. The bottom line? Personalize, and don't procrastinate.
At the ADA 2026 Scientific Sessions, experts debated whether patients with diabetes and chronic kidney disease (CKD) should start multiple therapies simultaneously or build up treatment step by step. The stakes are high — CKD combined with diabetes raises the risk of stroke, heart failure, kidney failure, and death — and an expanding toolkit of drugs (GLP-1 RAs, SGLT2 inhibitors, ns-MRAs, and more) means clinicians face meaningful choices about sequencing.
The case for sequential therapy: starting drugs one at a time allows clinicians to assess individual responses, identify adverse events more easily, and avoid overwhelming patients with treatment burden. The case for simultaneous therapy: evidence from trials like VERIFY and TRIPLE-AXEL suggests earlier, combined treatment leads to better long-term outcomes and may actually improve adherence — with sequential regimens showing a 62% treatment failure rate vs. 44% with upfront combination starts.
Key Takeaways:
Why it matters: With no one-size-fits-all answer, clinicians are urged to personalize treatment, avoid therapeutic inertia, and keep patients informed — because as one expert put it, "time is definitely nephrons."
