Introduction
Search Strategy
Consequences of CKD and DKD
Factors Contributing to DKD
Hyperglycemia
Hypertension
Dyslipidemia
Albuminuria
Diagnosis of DKD
Barriers to DKD Management
Patient-Specific Barriers
DKD Awareness
Education and Socioeconomic Status
Healthcare Literacy
Access to Health Insurance and Healthcare
Provider-Specific Barriers
DKD Awareness
Contact Time and Communication with Patient
Need for Early Referral to a Nephrologist
Treatment-Specific Barriers
Health System–Specific Barriers
Community-Specific Barriers
Recommendations for Better DKD Management
Patient and Physician Education
Optimal Screening
Risk Prediction Models
Multidisciplinary Care
Conclusion
Strategies to Improve DKD Outcomes
Improve targeting of high-risk patients | Enhance communication and education | Improve delivery of quality healthcare |
---|---|---|
Use of electronic health records to identify high-risk persons and alert providers | Enhanced patient-centered approaches | Use of DKD patient navigators as ESRD approaches |
Small area analysis to identify communities with higher rates of DKD/ESRD | Community-level education strategies to increase awareness of and impact on DKD risk factors | Advocacy for single-payer and/or disease- management health care systems |
Increased nephrology referral of patients with stage 3/4 DKD | Increased patient input into DKD care strategies | Increased system level support for PCPs |