TY - JOUR
T1 - Blood glucose and pressure controls in diabetic kidney disease
T2 - Narrative review of adherence, barriers and evidence of achievement
AU - Gardiner, Fergus William
AU - Nwose, Ezekiel Uba
AU - Bwititi, Phillip Taderera
AU - Crockett, Judith
AU - Wang, Lexin
N1 - Includes bibliographical references.
PY - 2018/1
Y1 - 2018/1
N2 - Aims: To review the epidemiology and the clinical evidence regarding achieving blood pressure (BP) and blood glucose control in patients with chronic kidney disease (CKD) and diabetes mellitus (DM), with emphasis on adherence and barriers within the context of Australian clinical guidelines. This article then considers Australian services aimed at BP, DM, and CKD, guideline adherence and control. Methods: Evidence from PubMed-listed articles published between 1994 and 2016 is considered, including original research, focusing on randomised controlled trials and prospective studies, review articles, meta- analyses, expert and professional bodies’ guidelines as well as our experience. Results: There have been no Australian studies that consider adherence to BP control in DM and CKD patients. This is a major limitation in preventing DM and renal disease progression. It is possible that Australian clinicians are not adhering to DM, hypertension (HT), and glucose recommendations, thus resulting in reduced patient outcomes. Conclusions: It is hoped that future studies ascertain the extent to which the required BP and glucose control in patients is achieved, and the potential barriers to adherence. The significance of this is immense since the impact of failure to control blood glucose levels and BP leads to renal damage.
AB - Aims: To review the epidemiology and the clinical evidence regarding achieving blood pressure (BP) and blood glucose control in patients with chronic kidney disease (CKD) and diabetes mellitus (DM), with emphasis on adherence and barriers within the context of Australian clinical guidelines. This article then considers Australian services aimed at BP, DM, and CKD, guideline adherence and control. Methods: Evidence from PubMed-listed articles published between 1994 and 2016 is considered, including original research, focusing on randomised controlled trials and prospective studies, review articles, meta- analyses, expert and professional bodies’ guidelines as well as our experience. Results: There have been no Australian studies that consider adherence to BP control in DM and CKD patients. This is a major limitation in preventing DM and renal disease progression. It is possible that Australian clinicians are not adhering to DM, hypertension (HT), and glucose recommendations, thus resulting in reduced patient outcomes. Conclusions: It is hoped that future studies ascertain the extent to which the required BP and glucose control in patients is achieved, and the potential barriers to adherence. The significance of this is immense since the impact of failure to control blood glucose levels and BP leads to renal damage.
KW - Chronic kidney disease
KW - Clinical management
KW - Diabetes mellitus
KW - Hypertension
KW - Renal disease
UR - http://www.scopus.com/inward/record.url?scp=85033439049&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85033439049&partnerID=8YFLogxK
U2 - 10.1016/j.jdiacomp.2017.09.008
DO - 10.1016/j.jdiacomp.2017.09.008
M3 - Review article
C2 - 29102249
AN - SCOPUS:85033439049
VL - 32
SP - 104
EP - 112
JO - Journal of Diabetes and Its Complications
JF - Journal of Diabetes and Its Complications
SN - 1056-8727
IS - 1
ER -