An evaluation of the impact of aggressive diabetes and hypertension management on chronic kidney diseases at the population level: a simulation analysis

John Pastor Ansah, Shawn Tan Yi Wei and Tessa Lui Shi Min

System Dynamics Review, 2020, vol. 36, issue 4, 497-522

Abstract: 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

Date: 2020
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