Section of Nephrology and Institute of Clinical and Translational Research, Baylor College of Medicine, and Michael E. DeBakey VA Medical Center, Houston, Texas (S.D.N.).
Monash University, School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia (S.Z.).
Ann Intern Med. 2021 Mar;174(3):385-394. doi: 10.7326/M20-5938. Epub 2020 Nov 10.
The Kidney Disease: Improving Global Outcomes (KDIGO) organization developed a clinical practice guideline in 2020 for the management of patients with diabetes and chronic kidney disease (CKD).
The KDIGO Work Group (WG) was tasked with developing the guideline for diabetes management in CKD. It defined the scope of the guideline, gathered evidence, determined systematic review topics, and graded evidence that had been summarized by an evidence review team. The English-language literature searches, which were initially done through October 2018, were updated in February 2020. The WG used the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to appraise evidence and rate the strength of the recommendations. Expert judgment was used to develop consensus practice points supplementary to the evidence-based graded recommendations. The guideline document underwent open public review. Comments from various stakeholders, subject matter experts, and industry and national organizations were considered before the document was finalized.
The guideline includes 12 recommendations and 48 practice points for clinicians caring for patients with diabetes and CKD. This synopsis focuses on the key recommendations pertinent to the following issues: comprehensive care needs, glycemic monitoring and targets, lifestyle interventions, antihyperglycemic therapies, and educational and integrated care approaches.
肾脏病：改善全球预后组织（KDIGO）于 2020 年制定了一份关于糖尿病和慢性肾脏病（CKD）患者管理的临床实践指南。
KDIGO 工作组（WG）负责制定 CKD 糖尿病管理指南。它确定了指南的范围，收集证据，确定了系统评价主题，并对证据审查小组总结的证据进行了分级。最初于 2018 年 10 月进行的英文文献检索在 2020 年 2 月进行了更新。WG 使用 GRADE（推荐评估、制定与评价）方法评估证据并对建议的强度进行分级。专家判断用于制定补充循证分级建议的共识实践要点。指南文件经过公开评审。在最终确定文件之前，考虑了来自不同利益相关者、主题专家以及行业和国家组织的意见。
该指南包括 12 项建议和 48 项针对照顾糖尿病和 CKD 患者的临床医生的实践要点。本概要重点介绍了与以下问题相关的关键建议：全面护理需求、血糖监测和目标、生活方式干预、抗高血糖治疗以及教育和综合护理方法。
