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Povzetek: International guidelines define standards of care for type 2 diabetes (T2D), obesity, cardiovascular disease (CVD), metabolic dysfunction-associated steatotic liver disease (MASLD) and chronic kidney disease (CKD). Yet implementation at the national level remains inconsistent, leading to persistent gaps between evidence-based recommendations and real-world practice. Key barriers include linguistic and cultural adaptation, limited communication to clinicians, and siloed regulatory and reimbursement processes. Addressing these challenges requires coordinated strategies, such as concise translations, digital platforms and decision-support tools, integration into medical education, and structured monitoring and evaluation frameworks with feedback and incentives. Equitable and sustainable access further depends on coordination between medical societies, governmental authorities, payers, and patient representatives. Evidence from existing initiatives shows that systematic, context-sensitive approaches can measurably improve care. Building on these lessons, this Commentary recommends priorities for national implementation to ensure that guidelines move more effectively from publication to practice and realise their full potential to improve patient outcomes.
Ključne besede: clinical practice guideline implementation, diabetes, obesity, cardiovascular disease, chronic kidney disease
Objavljeno v DiRROS: 04.09.2026; Ogledov: 31; Prenosov: 16
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Povzetek: The estimated glomerular filtration rate (eGFR) is a cornerstone of kidney function assessment. Widely used Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations based on serum creatinine (eGFRcr), cystatin C (eGFRcysC), or both (eGFRcr-cysC) are influenced by non-glomerular filtration rate (GFR) factors, and their performance may vary across clinical contexts. We retrospectively analyzed 435 adult patients with simultaneous serum creatinine and cystatin C measurements. eGFR was calculated using CKD-EPI 2021 (creatinine), CKD-EPI 2012 (cystatin C), and CKD-EPI 2021 (combined) equations. Patients were classified into Kidney Disease: Improving Global Outcomes (KDIGO) GFR categories (G1–G5), and discrepancies between equations were identified. 44 patients (10.1%) showed discordant GFR categorization across all three equations and underwent detailed clinical assessment. 16 of the 44 discordant cases had clinically confirmed chronic kidney disease (CKD). The combined equation aligned with the clinical diagnosis in all CKD cases. eGFRcr overestimated kidney function in 10/16 patients, while eGFRcysC produced lower values in 8/16, consistent with early CKD but potentially influenced by inflammation or obesity. Reclassification occurred in 9/16 patients when switching from eGFRcr to eGFRcr-cysC, including four who shifted from G2 to G3a–G4. A significant difference was observed between eGFRcr and eGFRcr-cysC (p < 0.05). The combined CKD-EPI equation demonstrated the best clinical concordance, supporting its broader use when diagnostic accuracy is essential.
Ključne besede: chronic kidney disease, glomerular filtration rate, eGFR, CKD-EPI, creatinine, cystatin C, GFR classification, diagnostic accuracy
Objavljeno v DiRROS: 06.03.2026; Ogledov: 461; Prenosov: 494
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Povzetek: The 10th Cardiovascular Outcome Trial (CVOT) Summit: Congress on Cardiovascular, Kidney, and Metabolic Outcomes was held virtually on December 5–6, 2024. This year, discussions about cardiovascular (CV) and kidney outcome trials centered on the recent findings from studies involving empagliflozin (EMPACT-MI), semaglutide (STEP-HFpEF-DM and FLOW), tirzepatide (SURMOUNT-OSA and SUMMIT), and finerenone (FINEARTS-HF). These studies represent significant advances in reducing the risk of major adverse cardiovascular events (MACE) and improving metabolic outcomes in heart failure with preserved ejection fraction (HFpEF), chronic kidney disease (CKD), and obstructive sleep apnea (OSA). The congress also comprised sessions on novel and established therapies for managing HFpEF, CKD, and obesity; guidelines for managing CKD and metabolic dysfunction-associated steatotic liver disease (MASLD); organ crosstalk and the development of cardio-kidney-metabolic (CKM) syndrome; precision medicine and person-centered management of diabetes, obesity, cardiovascular disease (CVD) and CKD; early detection of type 1 diabetes (T1D) and strategies to delay its onset; continuous glucose monitoring (CGM) and automated insulin delivery (AID); cardiovascular autonomic neuropathy (CAN) and the diabetic heart; and the role of primary care in the early detection, prevention and management of CKM diseases. The contribution of environmental plastic pollution to CVD risk, the increasing understanding of the efficacy and safety of incretin therapies in the treatment of CKM diseases, and the latest updates on nutrition strategies for CKM management under incretin-based therapies were also topics of interest for a vast audience of endocrinologists, diabetologists, cardiologists, nephrologists and primary care physicians, who actively engaged in online discussions. The 11th CVOT Summit will be held virtually on November 20–21, 2025 (http://www.cvot.org).
Ključne besede: cardiovascular disease, chronic kidney disease, CGM, CKM, diabetes, finerenone, GLP-1 RA, guidelines, heart failure, MASLD, obesity, SGLT2 inhibitor, tirzepatide
Objavljeno v DiRROS: 24.02.2026; Ogledov: 666; Prenosov: 301
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Povzetek: This dataset contains data from a study examining mental health and quality of life in adults with early-stage chronic kidney disease (CKD stages 2–4) and overweight or obesity. Data were collected from 40 patients using standardized questionnaires assessing symptoms of depression, anxiety, and quality of life, and were analyzed using descriptive statistics and correlation analyses.
Ključne besede: chronic kidney disease, obesity, mental health, lifestyle changes
Objavljeno v DiRROS: 09.01.2026; Ogledov: 1278; Prenosov: 345
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