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Current management of chronic kidney disease in type‐2 diabetes—A tiered approach: An overview of the joint Association of British Clinical Diabetologists and UK Kidney association ( ABCD ‐ UKKA ) guidelines

Indranil Dasgupta Orcid Logo, Sagen Zac‐Varghese, Khuram Chaudhry, Kieran McCafferty, Peter Winocour Orcid Logo, Tahseen A. Chowdhury Orcid Logo, Srikanth Bellary, Gabrielle Goldet, Mona Wahba, Parijat De, Andrew H. Frankel, Rosa M. Montero, Eirini Lioudaki, Debasish Banerjee Orcid Logo, Ritwika Mallik, Adnan Sharif, Naresh Kanumilli, Nicola Milne, Dipesh C. Patel, Ketan Dhatariya Orcid Logo, Steve Bain Orcid Logo, Janaka Karalliedde Orcid Logo

Diabetic Medicine

Swansea University Author: Steve Bain Orcid Logo

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DOI (Published version): 10.1111/dme.15450

Abstract

A growing and significant number of people with diabetes develop chronic kidney disease (CKD). Diabetes‐related CKD is a leading cause of end‐stage kidney disease (ESKD) and people with diabetes and CKD have high morbidity and mortality, predominantly related to cardiovascular disease (CVD). Despite...

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Published in: Diabetic Medicine
ISSN: 0742-3071 1464-5491
Published: Wiley 2024
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URI: https://cronfa.swan.ac.uk/Record/cronfa68024
Abstract: A growing and significant number of people with diabetes develop chronic kidney disease (CKD). Diabetes‐related CKD is a leading cause of end‐stage kidney disease (ESKD) and people with diabetes and CKD have high morbidity and mortality, predominantly related to cardiovascular disease (CVD). Despite advances in care over the recent decades, most people with CKD and type 2 diabetes are likely to die of CVD before developing ESKD. Hyperglycaemia and hypertension are modifiable risk factors to prevent onset and progression of CKD and related CVD. People with type 2 diabetes often have dyslipidaemia and CKD per se is an independent risk factor for CVD, therefore people with CKD and type 2 diabetes require intensive lipid lowering to reduce burden of CVD. Recent clinical trials of people with type 2 diabetes and CKD have demonstrated a reduction in composite kidney end point events (significant decline in kidney function, need for kidney replacement therapy and kidney death) with sodium‐glucose co‐transporter‐2 (SGLT‐2) inhibitors, non‐steroidal mineralocorticoid receptor antagonist finerenone and glucagon‐like peptide 1 receptor agonists. The Association of British Clinical Diabetologists (ABCD) and UK Kidney Association (UKKA) Diabetic Kidney Disease Clinical Speciality Group have previously undertaken a narrative review and critical appraisal of the available evidence to inform clinical practice guidelines for the management of hyperglycaemia, hyperlipidaemia and hypertension in adults with type 2 diabetes and CKD. This 2024 abbreviated updated guidance summarises the recommendations and the implications for clinical practice for healthcare professionals who treat people with diabetes and CKD in primary, community and secondary care settings.
Item Description: Invited Review
Keywords: ACE inhibitor, hypertension, kidney disease, lifestyle, type 2 diabetes
College: Faculty of Medicine, Health and Life Sciences