The draft of the KDIGO 2026 Clinical Practice Guideline for Acute Kidney Injury (AKI) and Acute Kidney Disease (AKD) is now available for public review through April 27, 2026.

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 disorders. It introduces an expanded framework encompassing both AKI and AKD, recognizing the continuum of kidney injury, recovery, and risk for chronic kidney disease.

Updated definitions incorporate both functional criteria and structural biomarkers to support earlier and more precise diagnosis, with increased emphasis on risk prediction, early identification, and prevention. New and revised recommendations address validated risk models, biomarkers, and electronic alerts, as well as fluid and hemodynamic management, drug and nephrotoxin stewardship, and contrast-associated AKI.

The guideline also includes updated 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 sections address pediatric and neonatal populations and considerations for implementation across diverse global settings.

Recommendations were developed by an international 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.

KDIGO welcomes feedback from clinicians, researchers, and other stakeholders. Reviewers are encouraged to focus on sections most relevant to their expertise. By submitting comments, you agree that KDIGO may acknowledge your contribution as a reviewer in the final publication.

Visit the guideline website to download the public review draft and submit comments via the feedback form.