KDIGO Updates Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease Patients

Introduction

The Kidney Disease: Improving Global Outcomes (KDIGO) organization is a global organization developing and implementing evidence-based clinical practice guidelines in kidney disease. They has updated their 2020 Clinical Practice Guideline for Diabetes Management to provide physicians with advice in treating patients with diabetes and chronic kidney disease (CKD). The new set of guidelines—published by the KDIGO Work Group—features 13 recommendations and 52 practice points for clinicians.

Reason for Update

The KDIGO Work Group published their first clinical practice guidelines on diabetes management for those with CKD just a few years earlier. However, the authors noted in their new guidelines that a reexamination was necessary because of the "wealth of high-quality new information that has quickly become available."

Evidence Evaluation

To evaluate the evidence, the KDIGO Work Group used the Grading of Recommendations Assessment, Development approach. The authors limited their literature searches to randomized controlled trials and conducted their search using each topic covered in the 2020 guidelines from December 2021. The searches were updated in February 2022 at the time of public review.

Recommendations

Layered Approach to Care

The KDIGO Work Group made several recommendations, including the promotion of a layered approach to care, which starts with lifestyle interventions and first-line pharmacotherapy.

Introduction of Medications

The introduction of renin-angiotensin system inhibitors, sodium–glucose cotransporter-2 inhibitors, mineralocorticoid receptor antagonist diuretics, and other antihypertensive medications was also recommended to improve intrarenal hemodynamics.

Focus on Kidney Function

The authors noted that preserving kidney function should be the main focus of physicians rather than replacing the kidney’s function thus diminishing the burden of other conditions such as heart failure.

Team-Based Focus on Care

Finally, the authors recommended the adoption of a team-based focus on care that focuses on risk evaluation and patient empowerment so the best quality of care is provided to the patient.

Conclusion

The authors wrote that the Work Group aimed to generate an updated guideline that is both rigorously devoted to existing evidence and clinically useful. The group made recommendations only when they were supported by high-quality evidence from a systematic review generated by the evidence review team.

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Related Articles

What is Chronic Kidney Disease?

What Do Your Kidneys Do?

References

New Guidelines for Treatment of CKD, Diabetes Emphasizes Comprehensive Care

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

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‍About the Author

Rich Foreman brings over 30 years of technology leadership to his role of CEO and Co-Founder of KidneySoft.  As founding CTO, Rich led the team that developed the CordicoShield / CordicoFire Wellness App. Cordico was honored with the Sacramento Innovation Award in 2021. After achieving a 7 digit ARR, Cordico was acquired by Lexipol in 2020. Rich has a BS in Industrial Engineering from the University of Washington, an MPA from Troy State University and was an officer in the U.S. Navy. Rich co-authored his book, "Tap into the Mobile Economy." Rich's blog was listed in Top 20 Marketing Mobile Blogs of 2014. He has been featured on KCRA3, NEWS10, 1170 Tech AM PowerDrive, Business Radio Money 105.5, SiliconIndia, the Sacramento Business Journal, and the Sacramento Bee. Rich is also the Founding Director of the Sacramento Chapter of Startup Grind and served a term as Utility Commissioner for the City of Folsom. Rich is a regular contributor to TechWire.net and StartupSac. Rich was the Co-founder of Apptology which was named Small Business of the Year in 2014 by the Sacramento Asian Pacific Chamber. He was also the Founding Chief Technology Officer at Cordico. Cordico was acquired by Lexipol in 2020.  Rich also served 4 years as a Naval Officer in the Civil Engineer Corps.

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Patient Education Disclaimer

This material is for informational purposes only. It does not replace the advice or counsel of a doctor or health care professional. KidneyLuv makes every effort to provide information that is accurate and timely, but makes no guarantee in this regard. You should consult with, and rely only on the advice of, your physician or health care professional.