Kelepouris Ellie, St Peter Wendy, Neumiller Joshua J, Wright Eugene E
Division of Renal Electrolyte and Hypertension, University of Pennsylvania, Philadelphia, PA, USA.
University of Minnesota, Minneapolis, MN, USA.
Diabetes Ther. 2023 Jul;14(7):1111-1136. doi: 10.1007/s13300-023-01416-2. Epub 2023 May 20.
Diabetes is the leading cause of chronic kidney disease (CKD), a condition associated with significant morbidity and mortality. As these patients have a high risk of developing cardiovascular disease and end-stage kidney disease, there is a need for early detection and early initiation of appropriate therapeutic interventions that slow disease progression and prevent adverse outcomes. Due to the complex nature of diabetes and CKD management, a holistic, patient-centered, collaborative care approach delivered by a coordinated multidisciplinary team (ideally including a clinical pharmacist as part of a comprehensive medication management program) is needed. In this review, we discuss the barriers to effective care, the current multidisciplinary approach used for CKD prevention and treatment, and the potential ways that the multidisciplinary management of CKD associated with type 2 diabetes mellitus can be refined to improve patient outcomes.
糖尿病是慢性肾脏病（CKD）的主要病因，慢性肾脏病与高发病率和高死亡率相关。由于这些患者发生心血管疾病和终末期肾病的风险很高，因此需要早期检测并尽早开始适当的治疗干预措施，以减缓疾病进展并预防不良后果。鉴于糖尿病和慢性肾脏病管理的复杂性，需要由协调的多学科团队（理想情况下包括临床药师作为综合药物管理计划的一部分）提供全面的、以患者为中心的协作式护理方法。在本综述中，我们讨论了有效护理的障碍、目前用于慢性肾脏病预防和治疗的多学科方法，以及如何优化2型糖尿病相关慢性肾脏病的多学科管理以改善患者预后。
