School of Community Health, Charles Sturt University, Australia; Calvary Hospital, ACT, Australia; School of Biomedical Sciences, Charles Sturt University, Australia.
School of Community Health, Charles Sturt University, Australia.
J Diabetes Complications. 2018 Jan;32(1):104-112. doi: 10.1016/j.jdiacomp.2017.09.008. Epub 2017 Sep 15.
To review the epidemiology and the clinical evidence regarding achieving blood pressure (BP) and blood glucose control in patients with chronic kidney disease (CKD) and diabetes mellitus (DM), with emphasis on adherence and barriers within the context of Australian clinical guidelines. This article then considers Australian services aimed at BP, DM, and CKD, guideline adherence and control.
Evidence from PubMed-listed articles published between 1994 and 2016 is considered, including original research, focusing on randomised controlled trials and prospective studies, review articles, meta- analyses, expert and professional bodies' guidelines as well as our experience.
There have been no Australian studies that consider adherence to BP control in DM and CKD patients. This is a major limitation in preventing DM and renal disease progression. It is possible that Australian clinicians are not adhering to DM, hypertension (HT), and glucose recommendations, thus resulting in reduced patient outcomes.
It is hoped that future studies ascertain the extent to which the required BP and glucose control in patients is achieved, and the potential barriers to adherence. The significance of this is immense since the impact of failure to control blood glucose levels and BP leads to renal damage.
回顾有关慢性肾脏病（CKD）和糖尿病（DM）患者实现血压（BP）和血糖控制的流行病学和临床证据，重点关注澳大利亚临床指南背景下的依从性和障碍。本文还考虑了澳大利亚针对 BP、DM 和 CKD、指南依从性和控制的服务。
考虑了 1994 年至 2016 年期间在 PubMed 列出的文章中的证据，包括原创研究，重点是随机对照试验和前瞻性研究、综述文章、荟萃分析、专家和专业机构的指南以及我们的经验。
没有澳大利亚的研究考虑到 DM 和 CKD 患者对 BP 控制的依从性。这是预防 DM 和肾脏疾病进展的主要障碍。澳大利亚临床医生可能没有遵守 DM、高血压（HT）和血糖建议，从而导致患者预后不佳。
希望未来的研究能够确定患者达到所需 BP 和血糖控制的程度，以及依从性的潜在障碍。这一点非常重要，因为未能控制血糖水平和 BP 会导致肾脏损伤。
