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October 2022
The American Diabetes Association and KDIGO Release Consensus Report on Diabetes Management in Chronic Kidney Disease (CKD)

The American Diabetes Association (ADA) and KDIGO released a Consensus Report on October 3, addressing diabetes management in chronic kidney disease (CKD). A joint writing group of ADA and KDIGO representatives reviewed and developed a series of consensus statements that provide clear direction for the implementation of care to improve clinical outcomes for people with diabetes and CKD. The organizations aligned in areas of CKD screening and diagnosis, glycemia monitoring, lifestyle therapies, treatment goals, and pharmacologic management.

“It is compelling that we now have a general agreement between diabetologists and nephrologists on how to diagnose and treat diabetic kidney disease in its early stages to markedly delay progression,” said co-author George Bakris, director of the Comprehensive Hypertension Center at the University of Chicago, Illinois. “This is a message for primary care physicians, and like any report, it should be translated by the caregiver to the patient so that both parties can agree on a common approach.”

“This report is all the more compelling given the recent advances in the field and dramatic public health toll that CKD poses,” added Robert Gabbay, MD, Ph.D., chief scientific and medical officer of the ADA.

“We are very proud to publish the first ever joint statement of the ADA and KDIGO, and grateful for our incredible joint writing group” said co-author, Ian de Boer, MD, MS, p
rofessor of medicine and adjunct professor of epidemiology at the University of Washington in Seattle, and co-chair of KDIGO’s forthcoming Diabetes in CKD Guideline update. “Now is the time to diagnose and treat diabetic kidney disease with evidence-based therapies.”

The ADA-KDIGO Consensus Report is published in 
Diabetes Care and Kidney International, and available on the KDIGO website.
KDIGO Hosts Controversies Conference on the Role of Complement in Kidney Disease

KDIGO held the 
Role of Complement in Kidney Diseases Controversies Conference in Florence, Italy, from September 29 to October 2. A global panel of multidisciplinary clinical and scientific expertise and a motivated group of patients and patient advocates (pictured above) convened to define the role of complement in a spectrum of kidney diseases, including glomerular disorders, vasculitides, hemolytic uremic syndrome and diabetic nephropathy.
 
The conference format involved topical plenary session presentations followed by focused discussion groups that reported on their areas to all attendees for consensus building. Conference participants will produce a Conference Report and a research agenda to serve as a roadmap to advance complement-kidney disease research and clinical investigations.
 
“We are delighted by the success of this conference and the rigorous evidence examination and debate among attendees,” said Dr. Smith. “There has not been a time where so much research and promise on potential therapies has been explored for such a wide group of renal diseases. And we could not have asked for a better group of attendees to develop meaningful guidance for improving the care and well-being of such a wide range of patients.”
 
For each disease addressed, attendees reviewed evidence of whether complement plays a primary or secondary role in disease etiology and/or progression. The debate included a critical examination of the value of complement biomarkers for monitoring disease course and whether specific drivers (i.e., genetic or acquired) dysregulate complement activity.
Numerous themes emerged from the conference, including the importance of data sharing to create more extensive data sets for rare diseases. This theme was cross-cutting among all the diseases covered. It was also movingly articulated during a panel of patients and patient advocates (pictured above), who shared specific stories of how their experiences were meaningfully impacted by lack of access to data, clinical trials, or emerging therapies.
 
“The patient voice was essential to our assessments and understanding of the impact of complement in kidney disease,” said Dr. Vivarelli. “The unique perspective they provide on patient-centered challenges, values, and preferences associated with these diseases will help clinicians worldwide improve both care and outcomes.”
KDIGO Announces Evidence Generation Deadlines for Updates to the Glomerular Diseases Guideline
KDIGO is updating the 2021 Clinical Practice Guideline on Glomerular Diseases (GD) on a chapter-by-chapter basis. Currently, the updates to the ANCA vasculitis and Lupus nephritis chapters are underway.

The KDIGO GD Guideline Work Group has announced that the updates to the chapters on IgA nephropathy (IgAN) and IgA vasculitis (IgAV), Nephrotic Syndrome (NS) in Children, and Minimal Change Disease (MCD) in Adults will kick off in Q1 of 2023.

Literature published by January 31, 2023 will be included in the initial evidence review for the IgAN/IgAV, NS, and MCD update. A second literature review will take place during the Public Review of the draft guideline. These updates will be targeted for publication between late 2023 and early 2024.

Because of the volume of clinical trials in the Lupus Nephritis and IgAN spaces, a second update of this chapter is expected for evidence generated between 2023 and January 31, 2025. 
Upcoming Events

ASN Kidney Week 2022
November 3 – 6, Orlando Florida
Are you attending ASN Kidney Week? Make sure to stop by the KDIGO Booth (#1110) to say hi to the team and learn more about the latest updates from KDIGO. Learn more and register.
New Resources

German Review of the KDIGO Nomenclature in CKD Conference Report

 

Check out the German review of the KDIGO Nomenclature in CKD Conference Report. The review, Nomenklatur für Nierenfunktion und Nierenkrankheiten, discusses the Conference Report from the KDIGO Consensus Conference on Nomenclature for Kidney Function and Disease held in Amsterdam, Netherlands in June of 2019. Read the review.

Russian Translation of the KDIGO Glomerular Diseases Guideline Key Takeaways

 

The KDIGO Glomerular Diseases (GD) Guideline Key Takeaways for Clinicians are now available in Russian. Download and read the Russian translation of the KDIGO GD Guideline Key Takeaways. Read the GD Guideline Key Takeaways for Clinicians in Russian.

Visit the KDIGO Glomerular Diseases Guideline Website to read the Key Takeaways in English.

Recording: Episode 4 of the KDIGO IgAN & FSGS Series, “Management, Treatment & Recommendations for Future Research in FSGS”

The recording is now available for Episode 4 of the KDIGO IgAN & FSGS Webinar Series, 
Management, Treatment, and Recommendations for Future Research in FSGS.

 

In Episode 4, Ladan Zand, MD, and Jai Radhakrishnan, MD, discuss the management and treatment of FSGS, including initial treatment of primary FSGS, treatment of steroid-resistant FSGS, and how to approach and manage relapse. This webinar also explores what’s ahead in FSGS treatment and recommendations for future research. Watch the recording.
About KDIGO

KDIGO is a Belgian foundation committed to developing and implementing nephrology guidelines that improve patient outcomes on a global basis. KDIGO is independent, volunteer-led, self-managed, and accountable to the public and the patients it serves. 
Learn More.

 

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