KDIGO has formally initiated a focused update to the KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease (CKD). The update will focus on Chapter 3 of the guideline, “Delaying CKD progression and managing its complications,” with particular attention to sections on medical management using newer therapies for people living with CKD.
The guideline update will be co-chaired by Adeera Levin, MD (Canada), and Paul Stevens, MB (United Kingdom), Co-Chairs of the 2024 CKD Guideline. The majority of the 2024 CKD Guideline Work Group will participate in the update process, ensuring continuity and expertise. The update will follow the rigorous KDIGO guideline development methodology, including systematic evidence review and multidisciplinary expert input. Updated systematic evidence reviews will inform the decision to update existing recommendations and practice points.
Important new data published following the 2024 CKD Guideline have identified the need to reassess several therapies that are changing the management of CKD. The Work Group will review and update evidence related to the use of sodium-glucose cotransporter 2 inhibitors (SGLT2i), glucagon-like peptide-1 (GLP-1)-based therapies, and nonsteroidal mineralocorticoid receptor antagonists (nsMRAs) in people with CKD without diabetes. Recommendations for CKD in people with diabetes are currently being updated separately by the KDIGO Diabetes in CKD Guideline Work Group.
“Since the publication of the 2024 KDIGO CKD Guideline, new data continue to emerge that have important implications for how we slow CKD progression and manage complications,” said Dr. Levin. “This focused update will ensure that KDIGO recommendations reflect the latest evidence and continue to support healthcare professionals caring for people living with CKD.”
“New cardiovascular and kidney outcomes trial data for SGLT2 inhibitors, GLP-1-based therapies, and nonsteroidal MRAs are raising important questions about how these therapies should be used in people with CKD who do not have diabetes,” said Dr. Stevens. “Our goal is to carefully review this evolving evidence and provide clear, practical guidance for healthcare professionals around the world.”
KDIGO CKD Guideline Focused Update Scope of Work
The Scope of Work for the 2026 CKD Update includes the three clinical questions below:
1. What is the effect of SGLT-2 inhibitors compared with placebo, usual care, or an active comparator among people with CKD but not type 2 diabetes in terms of mortality, progression of CKD, complications of CKD, and adverse events?
2. What is the effect of MRAs compared with placebo, usual care, or an active comparator among people with CKD but not type 2 diabetes in terms of mortality, progression of CKD, complications of CKD, and adverse events?
3. What is the effect of GLP-1 receptor agonists compared with placebo, usual care, or an active comparator among people with CKD but not type 2 diabetes in terms of mortality, progression of CKD, complications of CKD, and adverse events?
If you have any feedback on the Scope of Work, click here to submit comments through March, 24, 2026.
