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Obesity and overweight, which are common in patients with DM2, are a factors that favor the development/progression of CKD through both direct and indirect effects.69 Although the precise mechanisms the association between obesity and CKD are not totally defined it has been proposed that hypertension, glomerular hyperfiltration, hyperglycemia, lipid toxicity, inflammation or the role of adipose tissue and its adipokines are involved.70 Weight reduction by bariatric surgery, pharmacological treatment or dietary measures are associated with a nephroprotective effect,7173 so that weight reduction is a fundamental objective in the nephroprotection of patients with DKD

But Pennsylvania isnt alone in pursuing the policy shift

These are typically temporary and often dose-dependent, meaning they can improve over time or with a dosage adjustment

The likelihood of widespread damage to other patients that may lead to additional legal claims is significant

Dose titration of GLP-1 receptor agonists should follow manufacturer recommendations, typically starting at the lowest dose and increasing gradually every 4 weeks based on tolerability and glycaemic response