Diabetes Management in Chronic Kidney Disease: Synopsis of the KDIGO 2022 Clinical Practice Guideline Update

Research output: Contribution to journalJournal articleResearchpeer-review

  • Sankar D. Navaneethan
  • Sophia Zoungas
  • M. Luiza Caramori
  • Juliana C.N. Chan
  • Hiddo J.L. Heerspink
  • Clint Hurst
  • Adrian Liew
  • Erin D. Michos
  • Wasiu A. Olowu
  • Tami Sadusky
  • Nikhil Tandon
  • Katherine R. Tuttle
  • Christoph Wanner
  • Katy G. Wilkens
  • Jonathan C. Craig
  • David J. Tunnicliffe
  • Marcello Tonelli
  • Michael Cheung
  • Amy Earley
  • Ian H. de Boer
  • Kamlesh Khunti

Description: The KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease is an update of the 2020 guideline from Kidney Disease: Improving Global Outcomes (KDIGO). Methods: The KDIGO Work Group updated the guideline, which included reviewing and grading new evidence that was identified and summarized. As in the previous guideline, the Work Group used the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to appraise evidence and rate the strength of recommendations and expert judgment to develop consensus practice points. New evidence led to updating of recommendations in the chapters Comprehensive Care in Patients With Diabetes and CKD (Chapter 1) and Glucose-Lowering Therapies in Patients With T2D and CKD (Chapter 4). New evidence did not change recommendations in the chapters Glycemic Monitoring and Targets in Patients With Diabetes and CKD (Chapter 2), Lifestyle Interventions in Patients With Diabetes and CKD (Chapter 3), and Approaches to Management of Patients With Diabetes and CKD (Chapter 5). Recommendations: The updated guideline includes 13 recommendations and 52 practice points for clinicians caring for patients with diabetes and chronic kidney disease (CKD). A focus on preserving kidney function and maintaining well-being is recommended using a layered approach to care, starting with a foundation of lifestyle interventions, self-management, and first-line pharmacotherapy (such as sodium–glucose cotransporter-2 inhibitors) demonstrated to improve clinical outcomes. To this are added additional drugs with heart and kidney protection, such as glucagon-like peptide-1 receptor agonists and nonsteroidal mineralocorticoid receptor antagonists, and interventions to control risk factors for CKD progression and cardiovascular events, such as blood pressure, glycemia, and lipids.

Original languageEnglish
JournalAnnals of Internal Medicine
Volume176
Issue number3
Pages (from-to)381-387
Number of pages7
ISSN0003-4819
DOIs
Publication statusPublished - 1 Mar 2023

Bibliographical note

Funding Information:
Financial Support: This guideline is supported by KDIGO, and no funding is accepted for the development of specific guidelines.

Publisher Copyright:
© 2023 American College of Physicians. All rights reserved.

ID: 371024912