Management of chronic kidney disease in type 2 diabetes: screening, diagnosis and treatment goals, and recommendations

被引:18
|
作者
Shubrook, Jay H. [1 ]
Neumiller, Joshua J. [2 ]
Wright, Eugene [3 ]
机构
[1] Touro Univ Calif, Coll Osteopath Med, Vallejo, CA USA
[2] Washington State Univ, Coll Pharm & Pharmaceut Sci, Spokane, WA USA
[3] Charlotte Area Hlth Educ Ctr, Performance Improvement, Charlotte, NC USA
关键词
Diabetic kidney disease; type; 2; diabetes; chronic kidney disease; urinary albumin to creatinine ratio; ANGIOTENSIN-ALDOSTERONE SYSTEM; GLOMERULAR-FILTRATION-RATE; SGLT2; INHIBITORS; CARDIOVASCULAR OUTCOMES; RECEPTOR AGONISTS; GLYCEMIC CONTROL; FINERENONE; ALBUMINURIA; NEPHROPATHY; BLOCKADE;
D O I
10.1080/00325481.2021.2009726
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Patients with chronic kidney disease (CKD) and type 2 diabetes (T2D) are at high risk of CKD progression and cardiovascular (CV) disease. Prevalence of CKD in patients with T2D is currently around 40% and continues to grow. The increasing number of people with CKD and T2D will ultimately have a significant impact upon health resource use and costs of care for people with T2D. Management of CKD in patients with T2D aims to preserve kidney function to reduce the risk of end-stage kidney disease, CV events, and mortality. Evidence-based recommendations for the treatment of patients with CKD and T2D are provided by several international and national organizations and recommend several lifestyle and pharmacological approaches to help prevent or delay the progression of CKD in patients with T2D. Guidelines include regular screening of patients with T2D for CKD using spot urine albumin-to-creatinine ratio (UACR) and estimated glomerular filtration rate (at least annually and at least twice a year if UACR >300 mg/g). Additionally, assessment of vascular complications, together with interventions designed to improve glycemic control and lipid levels, maintain healthy body weight, and optimize blood pressure should be performed. Medications shown to slow progression of CKD include renin-angiotensin system inhibitors, sodium-glucose cotransporter-2 inhibitors, glucagon-like peptide 1 receptor agonists, and, more recently, selective, non-steroidal mineralocorticoid receptor antagonists. This review highlights the ongoing challenges facing primary care providers in the management of CKD in patients with T2D including the consideration of comorbidities, adoption of new treatment options, and implementation of individualized care. Achieving consensus for optimal treatment of this disease is critical in providing consistent and appropriate care for all patients. Strategies to improve outcomes should also include use of clear referral criteria, use of a multi-disciplinary approach, and patient education.
引用
收藏
页码:376 / 387
页数:12
相关论文
共 50 条
  • [11] Letter to the Editor Regarding "Importance of Early Screening and Diagnosis of Chronic Kidney Disease in Patients with Type 2 Diabetes"
    Nataraj, Megha
    Maiya, Arun G.
    Nagaraju, Shankar P.
    DIABETES THERAPY, 2022, 13 (09) : 1701 - 1703
  • [12] Treatment choices and targets in Type 2 diabetes and chronic kidney disease
    Lomova-Williams, L.
    Mallipedhi, A.
    Benjamin, S.
    Price, D. E.
    Stephens, J. W.
    DIABETIC MEDICINE, 2013, 30 : 162 - 162
  • [13] Treatment of type 2 diabetes mellitus in patients with chronic kidney disease
    Gomez-Huelgas, Ricardo
    Martinez-Castelao, Alberto
    Artola, Sara
    Gorriz, Jose Luis
    Menendez, Edelmiro
    MEDICINA CLINICA, 2014, 142 (02): : 85 - 85
  • [14] Antihyperglycemic Treatment Patterns for Chronic Kidney Disease and Type 2 Diabetes
    Betts, Keith A.
    Oberprieler, Nikolaus G.
    Wu, Aozhou
    James, Glen
    Beeman, Scott
    Gay, Alain
    He, Xuanhao
    Chen, Jingyi
    Vizcaya, David
    AMERICAN JOURNAL OF MANAGED CARE, 2024, 30 (09):
  • [15] Type 2 diabetes mellitus management in patients with chronic kidney disease: an update
    Kleinaki, Zoi
    Kapnisi, Stella
    Theodorelou-Charitou, Sofia-Andriani
    Nikas, Ilias P.
    Paschou, Stavroula A.
    HORMONES-INTERNATIONAL JOURNAL OF ENDOCRINOLOGY AND METABOLISM, 2020, 19 (04): : 467 - 476
  • [16] Type 2 diabetes mellitus management in patients with chronic kidney disease: an update
    Zoi Kleinaki
    Stella Kapnisi
    Sofia-Andriani Theodorelou-Charitou
    Ilias P. Nikas
    Stavroula A. Paschou
    Hormones, 2020, 19 : 467 - 476
  • [17] MANAGEMENT OF HYPERTENSION IN PATIENTS WITH TYPE 2 DIABETES MELLITUS AND CHRONIC KIDNEY DISEASE
    Timar, Bogdan
    Sima, Alexandra
    Vlad, Mihaela
    Timar, Romulus
    INTERDISCIPLINARY APPROACHES IN DIABETIC CHRONIC KIDNEY DISEASE, 2015, : 28 - 35
  • [18] A Response to: Letter to the Editor regarding “Importance of Early Screening and Diagnosis of Chronic Kidney Disease in Patients with Type 2 Diabetes”
    Neil Skolnik
    Alyssa Style
    Diabetes Therapy, 2022, 13 : 1705 - 1706
  • [19] A Response to: Letter to the Editor regarding "Importance of Early Screening and Diagnosis of Chronic Kidney Disease in Patients with Type 2 Diabetes"
    Skolnik, Neil
    Style, Alyssa
    DIABETES THERAPY, 2022, 13 (09) : 1705 - 1706
  • [20] SUDOSCAN, an effective tool for screening chronic kidney disease in patients with type 2 diabetes
    Mao, Fei
    Liu, Siying
    Qiao, Xiaona
    Zheng, Hangping
    Xiong, Qian
    Wen, Jie
    Zhang, Shuo
    Zhang, Zhaoyun
    Ye, Hongying
    Shi, Hongli
    Lu, Bin
    Li, Yiming
    EXPERIMENTAL AND THERAPEUTIC MEDICINE, 2017, 14 (02) : 1343 - 1350