National survey: Evaluation of cardiovascular risk factors in Thai patients with type 2 diabetes and chronic kidney disease after the development of cardiovascular disease. Issue 1 (17th December 2017)

• Record Type: Journal Article
• Authors: Changsirikulchai, Siribha; Sangthawan, Pornpen; Janma, Jirayut; Sripaiboonkij, Nintita; Rattanamongkolgul, Suthee; Thinkhamrop, Bandit
• Is Part Of: Nephrology. Volume 23:Issue 1(2018)
• Page Start: 53
• Page End: 59
• Publication Date: 2017-12-17
• Subjects: blood pressure -- cardiovascular disease -- cardiovascular risk -- chronic kidney disease -- glomerular filtration rate; Nephrology -- Periodicals; Kidneys -- Diseases -- Periodicals; Nephrologists -- Periodicals; 616.61; 616.61
• DOI: 10.1111/nep.12922
• Languages: English
• ISSNs: 1320-5358

Abstract

ABSTRACT: Aim: The aim of the present study was to evaluate the achievement in controlling the risk factors of cardiovascular diseases (CVD) in Thai patients with type 2 diabetes (T2DM) and chronic kidney disease (CKD). Methods: The DMHT dataset from 2011 to 2012, which was the cross‐sectional study of the national survey in Thai patients with T2DM was analyzed. Results: There were 1254 of 15 149 diabetic patients with estimated glomerular filtration rate (eGFR) less than 60 mL/min per 1.73 m 2 that had developed CVD for more than 12 months. The prevalence of CVD was 8.3%. The mean age in years was 68.2 with a standard deviation (SD) of 8.7. Males and females were 38.7 and 61.3%, respectively. The mean duration of diabetes was 8.5 (SD 0.2) years. The mean body mass index was 25.5 (SD 4.4) kg/m 2 . The percentage of patients with the target level of blood pressure control at ≤130/80 mm Hg was 47.1%. The percentage of patients who received angiotensin converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) was 58.9%. The percentage of patients with the target level of LDL control at <70 mg/dL was 17.2%. The percentage of patients with the target level of HbA1C at 7% was 39.2%. There were 63 (5.0%) patients having recurrent CVD. Conclusions: Most Thai patients with T2DM and CKD with eGFR < 60 mL/min per 1.73 m 2 could not achieve the therapeutic goals after the development of CVD. The national health policy should be planned to improve the quality of care to increase the number of patients who achieve the recommended goals. Summary at a Glance: This study is a national survey to evaluate status of care for controlling cardiovascular risk factors in Thai patients with type 2 diabetes and chronic kidney disease after the development of cardiovascular disease. It has been found that during the era of equal health accessibility in Thailand, most Thai patients with T2DM and CKD, at least stage 3, who had developed CVD could not achieve the therapeutic goals of the established risk factors when treated by physicians. The overall quality of care in these patients was comparable to those from the USA. The national health policy should be designed to improve the quality of care.