Promoting Kidney Health in People with Type 2 Diabetes

This two-part series by Fiona Murphy and Gobnait Byrne delves into the escalating incidence of chronic kidney disease (CKD), intricately linked to the risk factors shared with type 2 diabetes.

Promoting kidney health in people with type 2 diabetes: part 1 - British Journal of Nursing V.32(18), pages 874-880. Part 2 V.32(20, pages 964-971.

The articles emphasize the critical role of nurses in employing primary, secondary, and tertiary prevention strategies to mitigate the impact of these interconnected chronic conditions. Part 1 focuses on the significance of primary prevention, while Part 2 delves into secondary and tertiary prevention measures relevant to individuals with type 2 diabetes.

In Part 1, the articles explore the strong interconnection between CKD and type 2 diabetes, underscoring the importance of promoting kidney health. The discussion begins by describing CKD and type 2 diabetes, addressing their prevalence, and acknowledging the triple threat when combined with cardiovascular disease. The article advocates for primary preventive measures and provides practical examples to guide nurses in primary, community, secondary, and hospital care settings.

The need for mindfulness regarding the interrelationship between these long-term conditions is emphasized. Nurses are encouraged to take every opportunity to educate and empower individuals with type 2 diabetes, facilitating informed and active choices for their health outcomes and life goals. Part 1 discusses the relevance of primary prevention in promoting kidney health and highlights the strong interrelationship with cardiovascular concerns.

National and international best practice guidelines are cited, emphasizing the importance of promoting healthy lifestyles, including smoking cessation, alcohol reduction, maintaining a healthy diet, weight management, physical activity, and exercise. These guidelines are pertinent not only to promoting kidney health but also to diabetic and heart health.

Part 2 is previewed, promising a further exploration of promoting kidney health using secondary and tertiary preventive measures in individuals with type 2 diabetes. 

In Part 2, the article addresses the importance of timely diagnosis through screening for CKD, particularly in the context of diabetes-related CKD in low- and middle-income countries. Secondary prevention's role in reducing the estimated glomerular filtration rate decline is highlighted, emphasizing early referral to nephrology services.

The article continues to discuss the relevance of promoting kidney health using secondary and tertiary preventive measures in individuals with type 2 diabetes. Nurses are urged to screen for CKD, address major causes, and provide interventions for healthy lifestyles, obesity, and psychosocial care needs. Tertiary prevention is recognized as vital for enabling individuals to live well with these conditions, utilizing DSMES programs and pharmacological therapies to enhance quality of life and prevent complications.

In summary, this two-part series provides a comprehensive guide for nurses and healthcare professionals to navigate the complex interplay between CKD, type 2 diabetes, and cardiovascular disease. By focusing on prevention strategies at various levels, the articles underscore the importance of a holistic and proactive approach when managing these interconnected chronic conditions.

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