The Compatibility of the Treatment Modalities to the Recommendations of the Kidney Disease Outcomes Quality Initiative Guideline in Chronic Kidney Disease Patients with Diabetes

Zelal Adibelli; Cevdet Duran

doi:10.18502/ijph.v50i6.6419

Zelal Adibelli Division of Nephrology, Department of Internal Medicine, Usak University, School of Medicine, Usak, Turkey
Cevdet Duran Division of Endocrinology and Metabolism, Department of Internal Medicine, Usak University, School of Medicine, Usak, Turkey

DOI: https://doi.org/10.18502/ijph.v50i6.6419

Keywords: Chronic kidney disease; Diabetes mellitus; Treatment compliance

Abstract

Background: Diabetes mellitus (DM) and chronic kidney disease (CKD) are global growing health problems. Since DM is the major cause for CKD etiology, its development can be prevented with simple measures, like achievements of glycemic, lipid and blood pressure targets. This study aimed to evaluate whether the treatment goals for CKD patients with DM are achieved under the Kidney Disease Outcomes Quality Initiative (KDOQI) guideline.

Methods: Overall, 160 CKD patients with DM were enrolled in the study performed in Usak, Turkey from Jan 2016 to Jan 2018. Compatibility with treatment goals defined in KDOQI 2012 guideline for HbA1c levels, hypertension and dyslipidemia were evaluated retrospectively.

Results: Of 160 CKD patients [15 (9.4%) in stage 3a, 53 (33.1%) stage 3b, 51 (31.9%) stage 4 and 41 (25.6%) stage 5], 23 patients in stage 5 were on hemodialysis. Total compliance rate to hyperglycemia treatment was 94 of 160 patients (58.8%). Compatibility rates between different stages of CKD were similar. Hypertension was detected only in 134 patients. Sixty-six (49.3%) patients were compatible with the treatment goals, and as the CKD stages progressed, the rate of patients achieving hypertension treatment goals was declined (P=0.001). One-hundred and thirty-seven patients were not on hemodialysis and fifty-four (39.9%) of 137 patients achieved dyslipidemia goal. There was no difference between different stages of CKD.

Conclusion: Under KDOQI 2012 guideline, treatment goal for hyperglycemia was better achieved than the treatment goals for hypertension and dyslipidemia. In CKD patients with DM the physicians should be also focused on the treatment of hypertension and dyslipidemia.