Diabetes in CKD

The KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease (CKD) and Executive Summary are now published online in Supplement to Kidney International and Kidney International, respectively, and available on the KDIGO website. The Guideline was co-chaired by Ian de Boer, MD, MS (United States), and Peter Rossing, MD, DMSc (Denmark), who co-chaired the 2020 Guideline. The Work Group for this guideline also served on the 2020 Diabetes in CKD Guideline.

The KDIGO 2022 Diabetes in CKD Guideline follows only two years after the original clinical practice guideline on this topic in 2020. The update was motivated by the wealth of high-quality new information that has quickly become available since the 2020 guideline was published and by calls from the community to help guide the application of these new data. The short interval between guidelines reflects the rapid pace of advancement in the treatment of diabetes and CKD. 

Development of the Diabetes in CKD Guideline followed an explicit process of evidence review and appraisal. Treatment approaches and guideline recommendations are based on systematic reviews of relevant studies. Appraisal of the quality of the evidence and the strength of recommendations followed the ‘Grading of Recommendations Assessment, Development and Evaluation’ (GRADE) approach. Limitations of the evidence are discussed, with areas of future research also presented.  

The guideline is designed to apply to a broad population of patients with diabetes and CKD, while being mindful of implications for policy and payment. Type 1 and type 2 diabetes are both addressed, with differences in approach to management highlighted when appropriate. 

Additional Resources


KDIGO 2020 Diabetes in CKD Visual Guideline*

KDIGO 2020 Diabetes in CKD Infographic Set


*The artwork and technical implementation of this KDIGO Visual Guideline was supported by an educational grant from Bayer AG and AstraZeneca.



This Clinical Practice Guideline is based upon the best information available at the time of publication. The recommendations are designed to provide information and assist decision-making. They are not intended to define a standard of care, and should not be construed as one. Neither should they be interpreted as prescribing an exclusive course of management. Variations in practice will inevitably and appropriately occur when clinicians take into account the needs of individual patients, available resources, and limitations unique to an institution or type of practice. Every health care professional making use of this Guideline is responsible for evaluating the appropriateness of applying them in the setting of any particular clinical situation. The recommendations for research contained within this document are general and do not imply a specific protocol.