TY - JOUR
T1 - Management of Hypertension in Patients With Diabetic Kidney Disease
T2 - Summary of the Joint Association of British Clinical Diabetologists and UK Kidney Association (ABCD-UKKA) Guideline 2021
AU - Association of British Clinical Diabetologists and The UK Kidney Association
AU - Banerjee, Debasish
AU - Winocour, Peter
AU - Chowdhury, Tahseen A.
AU - De, Parijat
AU - Wahba, Mona
AU - Montero, Rosa
AU - Fogarty, Damian
AU - Frankel, Andrew
AU - Goldet, Gabrielle
AU - Karalliedde, Janaka
AU - Mark, Patrick B.
AU - Patel, Dipesh
AU - Pokrajac, Ana
AU - Sharif, Adnan
AU - Zac-Varghese, Sagen
AU - Bain, Stephen
AU - Dasgupta, Indranil
N1 - Funding Information:
DB reports receiving speaker fees from Vifor Pharma; honoraria for advisory board from Bayer; and research grant from AstraZeneca. PW reports receiving honoraria for delivering educational meetings and/or attending advisory boards for Abbott, AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, Merck Sharp & Dohme, Napp, Sanofi, Novo, and Vifor Pharmaceuticals. PD reports receiving honoraria for advisory work and/or lecture fees from AstraZeneca, Boehringer Ingelheim, Eli Lilly, Merck Sharp & Dohme, Napp Pharmaceuticals, Novo Nordisk, and Sanofi. DF reports receiving honoraria for delivering educational meetings and/or attending advisory boards for AstraZeneca, Napp, Boehringer Ingelheim, and Vifor Pharmaceuticals. JK reports receiving research grants from AstraZeneca and Sanofi and receiving speaker fees and attending advisory boards from Boehringer Ingelheim, AstraZeneca, Sanofi, and Napp. PBM reports receiving speaker fees and attending advisory board from Vifor, AstraZeneca, Pharmacomsos, Napp, Novartis, and Astellas and receiving grants from Boehringer Ingelheim. SCB reports receiving personal fees from Abbott, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Merck Sharp & Dohme, Novo Nordisk, and Sanofi-Aventis and being a shareholder in Glycosmedia. ID reports receiving research grants from Medtronic and Sanofi-Genzyme, receiving honoraria for attending advisory board and speaker meetings from GlaxoSmithKline, AstraZeneca, and Sanofi-Genzyme, and being the national lead for 3 GSK trials. All the other authors declared no competing interests.
Publisher Copyright:
© 2022 International Society of Nephrology
PY - 2022/4
Y1 - 2022/4
N2 - Diabetic kidney disease (DKD) accounts for >40% cases of chronic kidney disease (CKD) globally. Hypertension is a major risk factor for progression of DKD and the high incidence of cardiovascular disease and mortality in these people. Meticulous management of hypertension is therefore crucial to slow down the progression of DKD and reduce cardiovascular risk. Randomized controlled trial evidence differs in type 1 and type 2 diabetes and in different stages of DKD in terms of target blood pressure (BP). Renin-angiotensin blocking agents reduce progression of DKD and cardiovascular events in both type 1 and type 2 diabetes, albeit differently according to the stage of CKD. There is emerging evidence for the benefit of sodium glucose cotransporter 2, nonsteroidal selective mineralocorticoid antagonists, and endothelin-A receptor antagonists in slowing progression and reducing cardiovascular events in DKD. This UK guideline, developed jointly by diabetologists and nephrologists, has reviewed all available current evidence regarding the management of hypertension in DKD to produce a set of comprehensive individualized recommendations for BP control and the use of antihypertensive agents according to age, type of diabetes, and stage of CKD (https://ukkidney.org/sites/renal.org/files/Management-of-hypertension-and-RAAS-blockade-in-adults-with-DKD.pdf). A succinct summary of the guideline, including an infographic, is presented here.
AB - Diabetic kidney disease (DKD) accounts for >40% cases of chronic kidney disease (CKD) globally. Hypertension is a major risk factor for progression of DKD and the high incidence of cardiovascular disease and mortality in these people. Meticulous management of hypertension is therefore crucial to slow down the progression of DKD and reduce cardiovascular risk. Randomized controlled trial evidence differs in type 1 and type 2 diabetes and in different stages of DKD in terms of target blood pressure (BP). Renin-angiotensin blocking agents reduce progression of DKD and cardiovascular events in both type 1 and type 2 diabetes, albeit differently according to the stage of CKD. There is emerging evidence for the benefit of sodium glucose cotransporter 2, nonsteroidal selective mineralocorticoid antagonists, and endothelin-A receptor antagonists in slowing progression and reducing cardiovascular events in DKD. This UK guideline, developed jointly by diabetologists and nephrologists, has reviewed all available current evidence regarding the management of hypertension in DKD to produce a set of comprehensive individualized recommendations for BP control and the use of antihypertensive agents according to age, type of diabetes, and stage of CKD (https://ukkidney.org/sites/renal.org/files/Management-of-hypertension-and-RAAS-blockade-in-adults-with-DKD.pdf). A succinct summary of the guideline, including an infographic, is presented here.
KW - ACE inhibitors
KW - angiotensin receptor blockers
KW - chronic kidney disease
KW - diabetes
KW - dialysis
KW - hypertension
UR - http://www.scopus.com/inward/record.url?scp=85124524826&partnerID=8YFLogxK
U2 - 10.1016/j.ekir.2022.01.004
DO - 10.1016/j.ekir.2022.01.004
M3 - Review article
AN - SCOPUS:85124524826
SN - 2468-0249
VL - 7
SP - 681
EP - 687
JO - Kidney International Reports
JF - Kidney International Reports
IS - 4
ER -
