Until the results of this type of study are known, it will not be possible to determine if correction of dyslipidaemia alone exerts renoprotective effects. Furthermore, it is not known if intervention with specific agents such as statins or fibrates exerts effects on kidney end-points over and above protection from cardiovascular GPCR Compound Library events. Dyslipidaemia is a common finding in individuals with type 2 diabetes, particularly those with CKD, in whom it is a significant risk factor for adverse
cardiovascular outcomes27,37,38 (refer also to the NHMRC guidelines for the prevention of cardiovascular disease in type 2 diabetes). Moreover, the lowering of LDL cholesterol in individuals with type 2 diabetes leads to primary and secondary prevention of cardiovascular events and mortality.44
The absolute risk benefit of lipid lowering is much larger reflecting the increased absolute risk of adverse cardiovascular outcomes. Databases searched: The search strategies were designed to reduce bias and ensure that most of the relevant data available on type 2 diabetes were included in the present review and were Y-27632 research buy similar to those detailed in the Cochrane Collaboration Reviews Handbook (Higgins JPT et al.).45 The electronic databases searched were Medline, EMBASE, Cochrane Library, CINAHL, HTA and DARE. The detailed search strategy, research terms and yields are provided in Appendix 3 of the complete guideline document that can be found on the CARI website (http://www.cari.org.au). Date of searches: Blood Glucose – April 3, 2008 BP – March 18, 2008 Blood Lipids – March
27, 2008 Dietary Factors – March 28, 2008 Smoking Cessation – April 1, 2008. Improving glycaemic control reduces the development Aspartate and progression of kidney disease in people with type 2 diabetes (Evidence Level I – Intervention). The issue of the role of blood glucose control in the development and progression of kidney disease in individuals with type 2 diabetes has been addressed by a number of systematic reviews and RCTs. A summary of relevant studies is presented in Table A2 with key studies discussed in the text below. While a number of these studies have examined the use of specific antihyperglycaemic agents, it is not possible on the basis of the current evidence to provide recommendations of the use of specific agents in relation to the progression of CKD. The systematic review by Newman et al.4 addressed the question of whether improved glycaemic control reduces the rate of development of secondary diabetic complications in people with either type 1 or type 2 diabetes and microalbuminuria. Five RCTs were identified in people with type 2 diabetes. The review considered ESKD, estimation of the Glomerular Filtration Rate (eGFR) and clinical proteinuria with the following outcomes: No RCT evidence was identified to show that improved glycaemic control has any effect on the development of ESKD.