Back
For best output, select "Paper Size" as "A4" and "Margin" as "0" or "None".
To save or print to PDF, please select Print Destination > Save as PDF, enable Background Graphics under "More Settings", then click "Save".
During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Chronic kidney disease (CKD) has a global prevalence of >10% and is associated with comorbidities such as type 2 diabetes (T2D) and obesity. Sodium-glucose co-transporter 2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have demonstrated kidney benefits through pivotal clinical trials and are guideline-directed therapies. However, further clarity is needed on their optimal sequencing in clinical practice. This Delphi panel aimed to establish consensus on the use of these drug classes as foundational (part of first line) versus add-on therapies in adults with CKD and T2D with or without overweight/obesity.
In total, 114 healthcare professionals, involved in the management of adults with CKD and T2D across 10 countries, responded to Round 1 via an online survey platform. The statements covered topics including treatment goals, first-line therapy decisions, sequencing and combination use of SGLT2is and GLP-1 RAs, guideline interpretation, and practice gaps. Statement development was informed by a systematic literature review and a steering committee of 12 international experts. Consensus was pre-defined as a threshold of ≥75% of Delphi panelists agreeing/disagreeing with a 6-point Likert scale or choosing the same response for single/multiple-choice statements.
Based on interim data, 13/30 (43%) Round 1 statements reached consensus. Estimated glomerular filtration rate (eGFR), urinary albumin-to-creatine ratio (UACR), body mass index (BMI), and heart failure history were identified as key factors influencing first‑line treatment decisions, with trends in eGFR and UACR considered critical indicators of long‑term kidney protection.
Consensus was achieved (96%) that in adults with CKD, T2D, and overweight/obesity, kidney protection should be optimized even when weight or HbA1c targets are being met, emphasizing the importance of early intervention with nephroprotective agents beyond glycemic/weight control. Panelists also agreed (93%) that SGLT2is represent foundational therapy across BMI categories, supported by the panel’s agreement (97%) that SGLT2is offer earlier kidney benefits than GLP-1 RAs. GLP-1 RAs were preferred in profiles with high metabolic risk (high BMI and HbA1c) and established atherosclerotic cardiovascular disease (ASCVD) (Table), and as add-on therapy to SGLT2i for those with BMI ≥35 kg/m² and serious obesity-related comorbidities (95%).
Combination therapy with both agents was considered appropriate (96%) for adults with persistent kidney disease progression, high cardiovascular risk, or suboptimal metabolic control, though there was no consensus on whether initiation should be simultaneous or sequential. Cost and reimbursement constraints were most frequently cited as barriers to implementing guideline-directed therapies, underscoring the importance of health system structures in treatment uptake. The presentation will include results from subsequent Delphi rounds.
Conclusion: Based on Round 1, panelists favored SGLT2is as a foundational therapy for adults with CKD and T2D, with GLP-1 RAs considered for obesity, metabolic risk, ASCVD, or in combination with SGLT2i for persistent kidney disease progression. These initial insights emphasize kidney protection as an early treatment goal.
Acknowledgements: Funding: AstraZeneca; medical writing: Costello Medical.
