Heart and kidney disease in diabetes- challenges and emerging treatment options T2DM is the leading cause of chronic kidney disease (CKD) in many countries. CKD is also a major risk factor for adverse cardiovascular disease (CVD) outcomes. This complex interaction between the cardiac and renal systems creates a challenge for clinicians managing both diabetes and cardio-renal comorbidities. In this session, there will be a brief review the pathophysiological interaction between the cardiac and renal systems, and discuss how heart and kidney disease are intricately linked comorbidities of T2D. The suggested use and dose-adaption of glucose-lowering drugs according to CKD stage will be discussed along with case study and sharing of clinical experiences on practical steps for the clinical care of T2DM patients with CKD. The talk will also examine the various subanalyses and exploratory analyses of renal outcomes in recent CV outcome trials (CVOTs), with a focus on how the data might influence treatment decisions.