Promoting kidney health in people with type 2 diabetes: part 2
The incidence of chronic kidney disease is increasing internationally with many risk factors for chronic kidney disease also being risk factors for type 2 diabetes. Nurses should use primary, secondary and tertiary prevention to minimise the incidence of chronic kidney disease when caring for individuals with type 2 diabetes. This article is the second in a two-part series on the interrelationship between these long-term conditions. Part 1 addressed the significance of using primary prevention to promote kidney health in adults living with type 2 diabetes; part 2 will discuss the use of secondary and tertiary prevention relevant to these long-term conditions.
This article will address the relevance of promoting kidney health using secondary and tertiary preventive measures. It will provide examples to assist nurses and other multidisciplinary team members who work in primary or community care or secondary or hospital care settings to promote kidney health with adults who have type 2 diabetes. It will continue to recognise the triple threat of chronic kidney disease (CKD), type 2 diabetes and cardiovascular disease (CVD) described in part 1 (Murphy and Byrne, 2023).
The Kidney Disease: Improving Global Outcomes (KDIGO) 2022 clinical practice guideline for diabetes management in CKD states that individuals should be managed using a comprehensive approach to maximise both kidney and cardiovascular (CV) outcomes. This should incorporate a combination of lifestyle modification and self-management along with first-line drug therapies depending on patients' clinical characteristics. Additional medications with established kidney and cardiac protection should be incorporated as determined by assessments of remaining risk, and further interventions provided as required to manage additional risk factors (Rossing et al, 2022).
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