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Acute Kidney Injury (AKI) and Acute Kidney Disease (AKD)

The draft of the KDIGO 2026 Clinical Practice Guideline for Acute Kidney Injury (AKI) and Acute Kidney Disease (AKD) was recently made available for public review. The Guideline Work Group will prepare the guideline for publication based on feedback received during the public review.

This guideline represents the first major update to the KDIGO AKI Guideline since 2012 and reflects substantial advances in the understanding, detection, and management of acute kidney injury and related disorders. The updated guideline introduces an expanded framework that encompasses both AKI and AKD, recognizing the continuum of kidney injury, recovery, and risk of chronic kidney disease. Revised definitions incorporate both functional criteria and structural biomarkers to support earlier and more precise diagnosis, with greater emphasis on risk prediction, early identification, and prevention.

New recommendations address the use of validated risk models, biomarkers, and electronic alerts, as well as updated approaches to fluid and hemodynamic management, drug and nephrotoxin stewardship, and contrast-associated AKI. The guideline also includes revised guidance on kidney replacement therapy, including timing, modality selection, dosing, and discontinuation, along with new recommendations on follow-up care after AKI or AKD to reduce the risk of long-term adverse outcomes. Additional content addresses pediatric and neonatal populations, as well as implementation across diverse global practice settings.

Recommendations were developed by a Work Group, including patient representatives, using the GRADE methodology, ensuring transparency in the assessment of recommendation strength and the certainty of supporting evidence, in accordance with KDIGO’s rigorous scientific review standards.