A population-based study of 618,739 adults using electronic health record data, published in theClinical Journal of the American Society of Nephrologyby Katherine R. Tuttle, Lindsey M. Kornowske, Cami R. Jones, Christina L. Reynolds, Radica Z. Alicic, Kenn B. Daratha, Joshua J. Neumiller, O. Kenrik Duru, Susanne B. Nicholas, Meda E. Pavkov, on behalf of the CURE-CKD Consortium, has found that people with diabetes and reduced estimated glomerular filtration rate (eGFR) faced significantly higher risks of mortality and kidney failure. The study highlights how the coexistence of diabetes and impaired kidney function magnifies the risk burden, underscoring the importance of early recognition and proactive management in chronic kidney disease (CKD). The authors emphasize that protecting kidney and cardiovascular health requires an integrated and patient-centered approach, particularly for populations with overlapping metabolic and renal vulnerabilities. The real-world cohort analysis examined outcomes in a large population across diverse clinical settings, making the findings highly relevant to everyday practice. Patients with both diabetes and reduced eGFR consistently showed the highest incidence of death and kidney failure compared to those without diabetes or with preserved renal function. The results reflect the complex interplay between metabolic and renal pathways, where diabetes accelerates kidney injury, and impaired kidney function worsens cardiovascular and systemic risks. By leveraging real-world data, the study provides strong evidence that these patients represent a critical group requiring close monitoring, comprehensive care, and early interventions to prevent adverse outcomes. The authors conclude that clinicians should adopt integrated models of care that address both renal and cardiovascular complications in patients with diabetes and CKD. This includes optimizing blood glucose control, monitoring renal function, managing blood pressure, and incorporating lifestyle modifications. The findings also call for healthcare systems to prioritize coordinated strategies that reduce fragmentation in CKD management. As diabetes continues to rise globally, and CKD remains a leading cause of morbidity and mortality, the study strengthens the case for preventive strategies and patient-centered care to reduce disease burden.