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Management of Hypertension in Patients With Diabetic Kidney Disease: Summary of the Joint Association of British Clinical Diabetologists and UK Kidney Association (ABCD-UKKA) Guideline 2021

Debasish Banerjee Orcid Logo, Peter Winocour, Tahseen A. Chowdhury, Parijat De, Mona Wahba, Rosa Montero, Damian Fogarty, Andrew Frankel, Gabrielle Goldet, Janaka Karalliedde, Patrick B. Mark, Dipesh Patel, Ana Pokrajac, Adnan Sharif, Sagen Zac-Varghese, Steve Bain Orcid Logo, Indranil Dasgupta Orcid Logo

Kidney International Reports, Volume: 7, Issue: 4, Pages: 681 - 687

Swansea University Author: Steve Bain Orcid Logo

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Abstract

Diabetic kidney disease accounts for over 40% cases of chronic kidney disease globally. Hypertension is a major risk factor for progression of diabetic kidney disease and the high incidence of cardiovascular disease and mortality in these people. Meticulous management of hypertension is therefore cr...

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Published in: Kidney International Reports
ISSN: 2468-0249
Published: Elsevier BV 2022
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa59219
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Abstract: Diabetic kidney disease accounts for over 40% cases of chronic kidney disease globally. Hypertension is a major risk factor for progression of diabetic kidney disease 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 diabetic kidney disease and reduce cardiovascular risk. Randomized controlled trial evidence differs in type 1 and type 2 diabetes and in different stages of diabetic kidney disease in terms of target blood pressure. Renin angiotensin blocking agents reduce progression of diabetic kidney disease and cardiovascular events in both type 1 and type 2 diabetes, albeit differently according to the stage of chronic kidney disease. There is emerging evidence for the benefit of sodium glucose co-transporter-2, non-steroidal selective mineralocorticoid antagonists and endothelin-A receptor antagonists in slowing progression and reducing cardiovascular events in diabetic kidney disease. 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 blood pressure control and the use of antihypertensive agents according to age, type of diabetes and stage of chronic kidney disease (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.
Keywords: diabetes; hypertension; chronic kidney disease; dialysis; ACE inhibitors; angiotensin receptor blockers
College: Swansea University Medical School
Issue: 4
Start Page: 681
End Page: 687