KDIGO follows a comprehensive, evidence-based guideline development process in line with international standards for systematic reviews, evidence synthesis, and guideline development. This includes formulation of clinical questions using PICOS criteria (Population, Intervention, Comparator, Outcomes, Study Design), a formal systematic review and synthesis of the literature by an independent Evidence Review Team (often referred to as the ERT), stakeholder engagement, and structured consensus by a multidisciplinary Work Group. Recommendations are graded using the GRADE approach to assess the certainty of evidence and the strength of recommendations. 

KDIGO details its methodologies and processes in the KDIGO Methods Manual for Guideline Development.