European Renal Best Practice
May 28, 2015
Press Release -- First Guideline on Management of Patients with Diabetes and Chronic Kidney Disease (CKD)
 
28 May 2015
 
Diabetes mellitus is becoming increasingly prevalent and is considered a rapidly growing concern for healthcare systems. According to the WHO [1] there are currently more than 60 million patients with diabetes in Europe – and patients with diabetes are particularly at risk of developing chronic kidney disease. According to the latest annual report of the ERA-EDTA registry [2], 22.1% of all new dialysis patients are classified with diabetic nephropathy. Therefore it is to be feared that the global increase of diabetes will result in a higher prevalence of chronic kidney disease, too.
 
Despite the strong interplay between diabetes and CKD, the management of patients with diabetes and CKD stage 3b or higher (eGFR <45 mL/min) remains problematic. Many guidance-providing documents have been produced on the management of patients with diabetes to prevent or delay the progression to CKD, mostly defined as the presence of micro and macro-albuminuria. However, none of these documents specifically deal with the management of patients with CKD stage 3b or higher (eGFR <45 mL/min).
 
Now, the European Renal Best Practice (ERBP) group published the “Clinical Practice Guideline on management of patients with diabetes and chronic kidney disease stage 3b or higher (eGFR <45 mL/min)” online ahead of print in Nephrology Dialysis Transplantation (NDT), the leading nephrology journal in Europe.
 
“The guideline intends to provide an evidence-based rationale and, thus, to facilitate informed decision-making on the management of adult patients with diabetes mellitus and CKD”, explains Prof. Wim Van Biesen, chair of European Renal Best Practice. “A patient with diabetes and CKD has to be treated differently than a non-CKD patient with diabetes. Two things, especially, are important here: The adaptation of medication to renal function and, second, the consideration of the much higher risk for hypoglycemia in patients without chronic kidney disease. Therefore I believe, the guideline is very relevant and will have future impact.”

Read the full Guideline

[1] http://www.euro.who.int/en/health-topics/noncommunicable-diseases/diabetes/data-and-statistics

[2] http://www.era-edta-reg.org/files/annualreports/pdf/AnnRep2012.pdf