Closing the gap between evidence and practice in chronic kidney disease

被引:13
|
作者
Jardine, Meg J. [1 ,2 ]
Kasiske, Bertram [3 ,4 ]
Adu, Dwomoa [5 ]
Alrukhaimi, Mona [6 ]
Ashuntantang, Gloria E. [7 ]
Basnet, Shakti [8 ]
Chailimpamontree, Worawon [9 ]
Craig, Jonathan C. [10 ,11 ]
O'Donoghue, Donal J. [12 ,13 ]
Perkovic, Vlado [14 ]
Powe, Neil R. [15 ,16 ]
Roberts, Charlotte J. [17 ]
Suzuki, Yusuke [18 ]
Tanaka, Tetsuhiro [19 ]
Uhlig, Katrin [20 ,21 ]
机构
[1] Univ New South Wales Sydney, George Inst Global Hlth, Renal & Metab Div, Sydney, NSW, Australia
[2] Concord Repatriat Gen Hosp, Nephrol Unit, Sydney, NSW, Australia
[3] Hennepin Cty Med Ctr, Dept Med, Minneapolis, MN 55415 USA
[4] Univ Minnesota, Dept Med, Box 736 UMHC, Minneapolis, MN 55455 USA
[5] Univ Ghana, Sch Med & Dent, Dept Med & Therapeut, Accra, Ghana
[6] Dubai Med Coll, Dept Med, Dubai, U Arab Emirates
[7] Univ Yaounde I, Yaounde Gen Hosp, Fac Med & Biomed Sci, Yaounde, Cameroon
[8] Gautam Buddha Community Kidney Ctr, Dept Nephrol, Butwal, Nepal
[9] Bhumibol Adulyadej Hosp, Dept Med, Nephrol Div, Bangkok, Thailand
[10] Univ Sydney, Sch Publ Hlth, Dept Nephrol, Sydney, NSW, Australia
[11] Childrens Hosp Westmead, Ctr Kidney Res, Westmead, NSW, Australia
[12] Salford Royal Natl Hlth Serv NHS Fdn Trust, Dept Renal Med, Salford, Lancs, England
[13] Univ Manchester, Dept Renal Med, Manchester, Lancs, England
[14] Univ New South Wales Sydney, George Inst Global Hlth, Sydney, NSW, Australia
[15] Univ Calif San Francisco, Sch Med, Dept Med, San Francisco, CA 94143 USA
[16] Priscilla Chan & Mark Zuckerberg San Francisco Ge, Dept Med, San Francisco, CA USA
[17] Standardisat Int Consortium Hlth Outcomes Measure, London, England
[18] Juntendo Univ, Fac Med, Dept Nephrol, Tokyo, Japan
[19] Univ Tokyo, Sch Med, Div Nephrol & Endocrinol, Tokyo, Japan
[20] Keryx Biopharmaceut, Clin Dev, Boston, MA USA
[21] Tufts Univ, Sch Med, Dept Med, Boston, MA 02111 USA
关键词
chronic kidney disease; implementation; treatment gap; CARDIOVASCULAR OUTCOMES; RISK-MANAGEMENT; STATIN THERAPY; HEALTH-CARE; HEART; EMPAGLIFLOZIN; METAANALYSIS; PROGRESSION; BARRIERS;
D O I
10.1016/j.kisu.2017.07.006
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
There are major gaps between our growing knowledge of effective treatments for chronic kidney disease (CKD), and the delivery of evidence-based therapies to populations around the world. Although there remains a need for new, effective therapies, current evidence suggests that many patients with CKD are yet to fully realize the benefits of blood pressure-lowering drugs (with and without reducing proteinuria with renin-angiotensin system blockade), wider use of statins to reduce atherosclerotic cardiovascular disease events, and better glycemic control in both type 1 and type 2 diabetes. There are many barriers to optimizing evidence-based nephrology care around the world, including access to health care, affordability of treatments, consumer attitudes and circumstances, the dissemination of appropriate knowledge, the availability of expertise and structural impediments in the delivery of health care. Further investment in implementation science that addresses the major barriers to effective care in a cost-effective manner could yield both local and global benefits. Copyright (C) 2017, International Society of Nephrology. Published by Elsevier Inc. All rights reserved.
引用
收藏
页码:114 / 121
页数:8
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