DIABETES ACTION PLAN 2010

DIABETES ACTION PLAN 2010
QUALITY CARE FOR DIABETES IN SCOTLAND
3.5 Preventing renal disease
Where we want to be:
We want to be able to prevent the progression from chronic kidney disease (CKD) to
end-stage renal failure in people with diabetes to an extent that is comparable with the
best outcomes worldwide.
Why we want to get there:
Approximately 30% of people with type 1 diabetes and 20% of people with type 2
diabetes develop diabetic nephropathy. Renal vascular disease is also a common cause of
renal failure particularly in people with type 2 diabetes. Accelerated cardiovascular disease
in people with diabetes and renal disease is well recognised.
Diabetes is now the commonest reason for people starting renal replacement therapy in
Scotland.
Identification of chronic kidney disease in someone with diabetes should result in
treatment that slows the progression of renal disease, and improves cardiovascular risk
factor management.
The earlier we can identify chronic kidney disease, the sooner we can implement the
recommendations from SIGN Guideline 116 to delay its progression and support people
with diabetes to manage their condition. There are limited Scottish national data on the
prevalence of kidney disease in people with diabetes. The SDRN is working with the
Scottish Renal Registry, maintained by the Scottish Renal Association, to identify trends
and outcomes by linking to the data held by the Registry.
Actions we will take:
A series of initiatives will be undertaken to promote optimal kidney
function:
• Identify and provide information on the prevention and progression of diabetes
complications for people with diabetes and renal disease/chronic kidney disease
(responsibility: SDG/Scottish Renal Registry).
• The annual Scottish Diabetes Survey will report on eGFR rates through better
data linkage. Target 80% by 2011 (responsibility: Survey Monitoring Group/SCI-
DC).
• There should be clear pathways for referral between diabetes services and the
local nephrology service (responsibility: NHS Boards through their diabetes
MCNs).
• As part of its patient access programme, SCI-DC will work with Renal
PatientView to promote self management and ensure people with diabetes
understand the significance of results (responsibility: SCI-DC).
Healthcare Quality Dimensions: timely; safe; efficient.
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