Hypertension, RAA blockade in diabetes and kidney disease

A significant percentage of patients with diabetes develop chronic kidney disease (CKD), and diabetes is also a leading cause of end-stage renal disease.  More than a quarter of patients who are on dialysis in the UK have diabetes.  Diabetic kidney disease is associated with high morbidity and mortality, which are predominantly related to cardiovascular complications and the progression of kidney disease that requires renal replacement therapy. Hypertension is a modifiable risk factor for cardiovascular complications and progression of CKD.3

This guidance is for the variety of clinicians who manage patients with diabetic kidney disease, including GPs and specialists in diabetes, cardiology and nephrology. It intends to harmonise practices of blood pressure monitoring, and pharmacological and non-pharmacological management of hypertension, which may vary considerably.