In this episode of Clinical Conversations, Dr Marilena Giannoudi discusses cardiorenal metabolic disease with Dr Andrew Frankel. Their discussion provides an overview of this common cause of chronic kidney disease (CKD) and they focus on the management of cardiorenal metabolic disease, with Dr Frankel highlighting the importance of lifestyle management and patient education and engagement, and the pharmacotherapy 'four pillars' of RAAS inhibition, SGLT2 inhibition, blood pressure control, and MR antagonism. Explore this and more in this episode. Dr Andrew Frankel has been working as a consultant nephrologist at Imperial College Healthcare NHS trust since 1995 and works at the Imperial Renal and Transplant Centre, which is one of the largest kidney units in Europe catering for a population base of over three million. He has experience in managing all aspects of kidney disease but has a particular interest in relation to the management of kidney disease in the context of diabetes, cardiac disease and obesity. Dr Marilena Giannoudi is a cardiology registrar based in Leeds. She is Co-Chair of RCPE's Trainees and Members' Committee. -- Links -- NICE Guideline (NG203) - Chronic kidney disease: assessment and management https://www.nice.org.uk/guidance/ng203 2023 ESC Guidelines for the management of cardiovascular disease in patients with diabetes https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/CVD-and-Diabetes-Guidelines For Kidneys Sake Podcast - By Dr Andrew Frankel and colleagues https://www.forkidneyssake.com/ Recording date: 24 November 2025 -- Follow us -- https://www.instagram.com/rcpedintrainees https://x.com/RCPEdinTrainees -- Upcoming RCPE events -- https://www.rcpe.ac.uk/events -- Become an RCPE Member -- https://www.rcpe.ac.uk/membership/join-college Feedback: [email protected] This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).