Diabetes Management in Chronic Kidney Disease: Synopsis of the KDIGO 2022 Clinical Practice Guideline Update.

Autor:	Navaneethan SD; Section of Nephrology, Department of Medicine, Selzman Institute for Kidney Health, Baylor College of Medicine, Institute of Clinical and Translational Research, Baylor College of Medicine, and Section of Nephrology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas (S.D.N.)., Zoungas S; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia (S.Z.)., Caramori ML; Department of Endocrinology and Metabolism, Cleveland Clinic Foundation, Cleveland, Ohio, and Division of Diabetes, Endocrinology and Metabolism, University of Minnesota, Minneapolis, Minnesota (M.L.C.)., Chan JCN; Department of Medicine and Therapeutics, Hong Kong Institute of Diabetes and Obesity, and Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Hong Kong, China (J.C.N.C.)., Heerspink HJL; Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands (H.J.L.H.)., Hurst C; Houston, Texas (C.H.)., Liew A; The Kidney & Transplant Practice, Mount Elizabeth Novena Hospital, Singapore (A.L.)., Michos ED; Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland (E.D.M.)., Olowu WA; Pediatric Nephrology and Hypertension Unit, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, State of Osum, Nigeria (W.A.O.)., Sadusky T; Seattle, Washington (T.S.)., Tandon N; Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India (N.T.)., Tuttle KR; Division of Nephrology, University of Washington, Spokane, Washington (K.R.T.)., Wanner C; Division of Nephrology, University Hospital of Würzburg, Würzburg, Germany (C.W.)., Wilkens KG; Nutrition and Fitness Services, Northwest Kidney Centers, Seattle, Washington (K.G.W.)., Craig JC; College of Medicine and Public Health, Flinders University, Adelaide, South Australia, and Cochrane Kidney and Transplant, Sydney, New South Wales, Australia (J.C.C.)., Tunnicliffe DJ; Cochrane Kidney and Transplant and Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia (D.J.T.)., Tonelli M; Department of Medicine, University of Calgary, Calgary, Alberta, Canada (M.T.)., Cheung M; KDIGO, Brussels, Belgium (M.C., A.E.)., Earley A; KDIGO, Brussels, Belgium (M.C., A.E.)., Rossing P; Steno Diabetes Center Copenhagen and University of Copenhagen, Copenhagen, Denmark (P.R.)., de Boer IH; Kidney Research Institute, University of Washington, Seattle, Washington (I.H.B.)., Khunti K; Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, United Kingdom (K.K.).
Jazyk:	angličtina
Zdroj:	Annals of internal medicine [Ann Intern Med] 2023 Mar; Vol. 176 (3), pp. 381-387. Date of Electronic Publication: 2023 Jan 10.
DOI:	10.7326/M22-2904
Abstrakt:	Description: The KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease is an update of the 2020 guideline from Kidney Disease: Improving Global Outcomes (KDIGO). Methods: The KDIGO Work Group updated the guideline, which included reviewing and grading new evidence that was identified and summarized. As in the previous guideline, the Work Group used the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to appraise evidence and rate the strength of recommendations and expert judgment to develop consensus practice points. New evidence led to updating of recommendations in the chapters Comprehensive Care in Patients With Diabetes and CKD (Chapter 1) and Glucose-Lowering Therapies in Patients With T2D and CKD (Chapter 4). New evidence did not change recommendations in the chapters Glycemic Monitoring and Targets in Patients With Diabetes and CKD (Chapter 2), Lifestyle Interventions in Patients With Diabetes and CKD (Chapter 3), and Approaches to Management of Patients With Diabetes and CKD (Chapter 5). Recommendations: The updated guideline includes 13 recommendations and 52 practice points for clinicians caring for patients with diabetes and chronic kidney disease (CKD). A focus on preserving kidney function and maintaining well-being is recommended using a layered approach to care, starting with a foundation of lifestyle interventions, self-management, and first-line pharmacotherapy (such as sodium-glucose cotransporter-2 inhibitors) demonstrated to improve clinical outcomes. To this are added additional drugs with heart and kidney protection, such as glucagon-like peptide-1 receptor agonists and nonsteroidal mineralocorticoid receptor antagonists, and interventions to control risk factors for CKD progression and cardiovascular events, such as blood pressure, glycemia, and lipids.
Databáze:	MEDLINE
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