Multidisciplinary management of diabetic kidney disease: a systematic review protocol

Abstract

Review question/objective The goal of this systematic review is to identify the best available evidence regarding multidisciplinary management of diabetes related kidney disease. More specifically, this analysis aims to answer the question: is the multidisciplinary management of diabetic kidney disease effective in improving health-related patient outcomes? Inclusion criteria Types of participants This review will consider studies that include: 1.Adults aged >18 years old 2.Diagnosed with type 1 or type 2 diabetes, according to the WHO criteria (WHO 2006): fasting plasma glucose ≥ 7.0 mmol/L and two hour plasma glucose ≥ 11.1 mmol/L.35 3.Diagnosed with Chronic Kidney Disease stage one to five, based on the urine albumin excretion ratio according to the KDOQI 2007 criteria. Types of intervention(s)/phenomena of interest This review will consider studies that include the following types of interventions: 1.Multidisciplinary management programs or programs that include an approach or intervention from more than one medical or allied health discipline (for example nurses, pharmacists, dieticians, or health educators) for the management of Diabetic Kidney Disease, that aims to prevent the decline in kidney function, control the progression of kidney disease, improve glycemic and/or blood pressure control or improve patients’ quality of life. 2.Comparison of multidisciplinary programs with any other treatment (including standard disease management approaches) or with retrospective (historical) outcome data. 3.Structured care plans provided by more than one healthcare discipline including physicians, nurses, pharmacists, dieticians, or health educators. 4.Multidisciplinary intervention conducted in an outpatient setting defined as an ambulatory clinic, home care/work place setting or a combination of both (hybrid). Types of outcomes This review will consider studies that include the following health-related outcomes: in the absence of validated objective or subjective self-report instruments, unvalidated self-report data will be included as the lowest level of data assessing outcomes among Diabetic Kidney Disease patients. A.Primary clinical outcomes: 1.Changes or decline in kidney function evaluated through the measurement of creatinine clearance and/or glomerular filtration rate and/or serum creatinine and/or proteinuria. 2.Incidence of kidney failure evidenced by the start of renal replacement therapy either by hemodialysis or peritoneal dialysis. B.Primary patient reported outcomes: 1.Generic or specific health-related quality of life (including assessment of depression, anxiety and TRUNCATED AT 350 WORDS