Chronic kidney disease screening and renoprotection in type 2 diabetes

Ann Afr Med. 2009 Jan-Mar;8(1):52-4. doi: 10.4103/1596-3519.55765.

Abstract

Background: Type 2 diabetes (T2D) is a major cause of chronic kidney disease. Control of hypertension and the use of angiotensin converting enzyme inhibitors (ACEI) and/or angiotensin II receptor blockers especially in those with proteinuria have been shown to protect against chronic kidney disease and delay its progression to kidney failure.

Methods: We reviewed the medical records of 169 patients at 12 months with a view of auditing the screening for chronic kidney disease and the use of renoprotective measures.

Results: Urinalysis was done in 49.1% and serum creatinine in 50.3%. No patient had glomerular filtration rate estimated. Seventy nine (67.6%) of the hypertensive patients were on anti-hypertensives. ACEI was used in 49 (45.8%) of these patients BP control was optimal in 29.1%.

Conclusion: There is poor adherence to guidelines on chronic kidney disease screening and renoprotection in T2D.

MeSH terms

  • Adult
  • Aged
  • Angiotensin-Converting Enzyme Inhibitors / adverse effects
  • Antihypertensive Agents / adverse effects
  • Clinical Audit / methods*
  • Creatinine / blood
  • Diabetes Mellitus, Type 2 / complications*
  • Disease Progression
  • Female
  • Guideline Adherence
  • Hospitals, Teaching
  • Humans
  • Hypertension / complications
  • Hypertension / drug therapy
  • Kidney Failure, Chronic / diagnosis*
  • Kidney Failure, Chronic / etiology
  • Kidney Failure, Chronic / prevention & control
  • Male
  • Middle Aged
  • Outcome and Process Assessment, Health Care*
  • Practice Guidelines as Topic
  • Proteinuria / physiopathology
  • Urinalysis / methods

Substances

  • Angiotensin-Converting Enzyme Inhibitors
  • Antihypertensive Agents
  • Creatinine