Elkeraie Ahmed Fathi, Al-Ghamdi Saeed, Abu-Alfa Ali K, Alotaibi Torki, AlSaedi Ali Jasim, AlSuwaida Abdulkareem, Arici Mustafa, Ecder Tevfik, Ghnaimat Mohammad, Hafez Mohamed Hany, Hassan Mohamed H, Sqalli Tarik
Department of Internal Medicine and Nephrology, Alexandria University, Alexandria, Egypt.
Department of Medicine, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
Int J Nephrol Renovasc Dis. 2024 Jan 3;17:1-16. doi: 10.2147/IJNRD.S430532. eCollection 2024.
Chronic kidney disease (CKD) is a major public health concern in the Middle East and Africa (MEA) region and a leading cause of death in patients with type 2 diabetes mellitus (T2DM) and hypertension. Early initiation of sodium-glucose cotransporter - 2 inhibitors (SGLT-2i) and proper sequencing with renin-angiotensin-aldosterone system inhibitors (RAASi) in these patients may result in better clinical outcomes due to their cardioprotective properties and complementary mechanisms of action. In this review, we present guideline-based consensus recommendations by experts from the MEA region, as practical algorithms for screening, early detection, nephrology referral, and treatment pathways for CKD management in patients with hypertension and diabetes mellitus. This study will help physicians take timely and appropriate actions to provide better care to patients with CKD or those at high risk of CKD.
慢性肾脏病(CKD)是中东和非洲(MEA)地区主要的公共卫生问题,也是2型糖尿病(T2DM)和高血压患者的主要死因。在这些患者中,早期启用钠-葡萄糖协同转运蛋白2抑制剂(SGLT-2i)并与肾素-血管紧张素-醛固酮系统抑制剂(RAASi)进行合理序贯治疗,因其心脏保护特性和互补的作用机制,可能会带来更好的临床结局。在本综述中,我们展示了MEA地区专家基于指南的共识性建议,作为高血压和糖尿病患者CKD管理的筛查、早期检测、肾病转诊及治疗途径的实用算法。本研究将帮助医生及时采取适当行动,为CKD患者或CKD高危患者提供更好的护理。