ABCD renal position statements & update
People living with diabetes and kidney disease (DKD) have a much greater risk of both kidney failure and cardiovascular disease.
Management is complex and needs to take anaemia, foot, eye, and bone health into consideration
Management of lipids , blood pressure and glycaemia all require a tailored approach depending on the type of diabetes and extent of renal disease and co-morbidity
The updated ABCD Renal Association guidelines include information on new therapeutic approaches and suggest new evidence based strategies for managing DKD and post transplantation diabetes (PTDM).
- Aim for lower non HDL cholesterol with lipid lowering therapy in DKD (statins , ezetimibe, and less often fenofibrate and PCSK inhibitors)
- Confirm hypertension with home readings, aim for BP 130-140/80-90 depending on albuminuric status – when preferential RAAS blockade , consider modest reduction eGFR if benefiting cardiac failure
- Individualised HbA1c targets in DKD and wider use of gliflozins and GLP1 analogues with cardiorenal benefit independent of glycaemic lowering
- Assess risk of PTDM and take this into consideration with immunosuppressive regime , with tailored glycaemic management and insulin for symptomatic hyerglycaemia
Tuesday 29 October 2019
17:30 - 18:10