Blood glucose and pressure controls in diabetic kidney disease: Narrative review of adherence, barriers and evidence of achievement

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Abstract

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.

Original languageEnglish
Pages (from-to)104-112
Number of pages9
JournalJournal of Diabetes and Its Complications
Volume32
Issue number1
Early online dateSep 2017
DOIs
Publication statusPublished - Jan 2018

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Diabetic Nephropathies
Blood Glucose
Diabetes Mellitus
Blood Pressure
Chronic Renal Insufficiency
Guidelines
Guideline Adherence
Kidney
PubMed
Disease Progression
Meta-Analysis
Epidemiology
Randomized Controlled Trials
Prospective Studies
Hypertension
Glucose
Research

Cite this

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title = "Blood glucose and pressure controls in diabetic kidney disease: Narrative review of adherence, barriers and evidence of achievement",
abstract = "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.",
keywords = "Chronic kidney disease, Clinical management, Diabetes mellitus, Hypertension, Renal disease",
author = "Gardiner, {Fergus William} and Nwose, {Ezekiel Uba} and Bwititi, {Phillip Taderera} and Judith Crockett and Lexin Wang",
note = "Includes bibliographical references.",
year = "2018",
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doi = "10.1016/j.jdiacomp.2017.09.008",
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volume = "32",
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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

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