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
Author(s)
Type
Journal Article
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.
Date Issued
2025-02-01
Date Acceptance
2024-09-27
Citation
Diabetic Medicine, 2025, 42 (2)
ISSN
0742-3071
Publisher
Wiley
Journal / Book Title
Diabetic Medicine
Volume
42
Issue
2
Copyright Statement
© 2024 The Author(s). Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/39415639
Subjects
ACE inhibitior
CARDIOVASCULAR OUTCOMES
CARE
EFFICACY
Endocrinology & Metabolism
EVENTS
GLP-1 RECEPTOR AGONISTS
hypertension
kidney disease
LDL CHOLESTEROL
Life Sciences & Biomedicine
lifestyle
METAANALYSIS
MORTALITY
SAFETY
Science & Technology
THERAPY
type 2 diabetes
Publication Status
Published
Coverage Spatial
England
Article Number
e15450
Date Publish Online
2024-10-17