Associated with undesirable clinical outcomes including cardiovascular events, kidney failure, and poor quality of life, Chronic Kidney Disease (CKD) is an emerging noncommunicable disease globally. Treatment costs and CKD complications result in an enormous burden on the healthcare system. Randomized control trials suggest that CKD outcomes can improve if individuals with diabetes and hypertension are adequately managed, raising what‐if questions at the population level. This research aims to explore the impact of aggressive diabetes and hypertension management on CKD outcomes. Based on data from randomized control trials, the Singapore Renal Registry, and the literature, a system dynamics simulation model was developed. Results suggest that the key to reducing the burden of CKD at the population level is identifying and aggressively managing individuals with prehypertension and hypertension to reduce risk of developing CKD events. Combined interventions focusing on aggressive diabetes and hypertension management have the biggest impact on CKD outcomes. © 2021 System Dynamics Society

中文翻译：

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在人群水平上评估积极的糖尿病和高血压管理对慢性肾脏病的影响：模拟分析

与不良的临床结果（包括心血管事件，肾衰竭和不良的生活质量）相关，慢性肾脏病（CKD）是全球范围内一种新兴的非传染性疾病。治疗费用和CKD并发症给医疗保健系统带来了沉重负担。随机对照试验表明，如果对糖尿病和高血压患者进行适当管理，CKD结局可以改善，从而在人群水平上提出假设问题。这项研究旨在探讨积极的糖尿病和高血压管理对CKD结局的影响。基于来自随机对照试验，新加坡肾脏病登记处和文献的数据，开发了系统动力学仿真模型。结果表明，在人群水平上减轻CKD负担的关键是识别并积极管理患有高血压前期和高血压的个体，以减少发生CKD事件的风险。以积极的糖尿病和高血压治疗为重点的联合干预措施对CKD结局的影响最大。©2021系统动力学学会