Quality of care for people with chronic kidney disease: a systematic review and meta-analysis.

A retrospective cohort study in Singapore (n=10 245) 75 reported an increasing trend in statin prescription rates, rising from 81% in 2007 to 87.1% in 2011.

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For example, studies in Taiwan 11 and Singapore show increases in ACEIs/ARBs use, while in the USA, data indicate a decreasing trend. 75 Such differences may be attributed to variations in a range of patient, clinician and health system-level barriers including awareness of CKD and clinical practice guidelines, 84 suboptimal medication adherence and fragmentation of health services relevant to the care of complex patient populations. 16 84 Our subgroup analysis based on the timing of studies relative to release of KDIGO 2012 did not identify evidence of significant improvements in BP control and use of recommended medications including ACEIs/ARBs following the publication of the guidelines.

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