Executive summary of the 2020 KDIGO Diabetes Management in CKD Guideline: evidence-based advances in monitoring and treatment

Ian H. de Boer, M. Luiza Caramori, Juliana C.N. Chan, Hiddo J.L. Heerspink, Clint Hurst, Kamlesh Khunti, Adrian Liew, Erin D. Michos, Sankar D. Navaneethan, Wasiu A. Olowu, Tami Sadusky, Nikhil Tandon, Katherine R. Tuttle, Christoph Wanner, Katy G. Wilkens, Sophia Zoungas, Lyubov Lytvyn, Jonathan C. Craig, David J. Tunnicliffe, Martin HowellMarcello Tonelli, Michael Cheung, Amy Earley, Peter Rossing

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

The Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease represents the first KDIGO guideline on this subject. The guideline comes at a time when advances in diabetes technology and therapeutics offer new options to manage the large population of patients with diabetes and chronic kidney disease (CKD) at high risk of poor health outcomes. An enlarging base of high-quality evidence from randomized clinical trials is available to evaluate important new treatments offering organ protection, such as sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists. The goal of the new guideline is to provide evidence-based recommendations to optimize the clinical care of people with diabetes and CKD by integrating new options with existing management strategies. In addition, the guideline contains practice points to facilitate implementation when insufficient data are available to make well-justified recommendations or when additional guidance may be useful for clinical application. The guideline covers comprehensive care of patients with diabetes and CKD, glycemic monitoring and targets, lifestyle interventions, antihyperglycemic therapies, and self-management and health systems approaches to management of patients with diabetes and CKD.

Original languageEnglish (US)
Pages (from-to)839-848
Number of pages10
JournalKidney international
Volume98
Issue number4
DOIs
StatePublished - Oct 2020

Bibliographical note

Funding Information:
A special debt of gratitude is owed to following people for their contribution to this important guideline effort: Melissa Thompson, Debbie Maizels, Suetonia C. Palmer, Giovanni F.M. Strippoli, Fiona Russell, Gail Y. Higgins, Tess E. Cooper, Nicole Evangelidis, Brydee Cashmore, Rabia Khalid, Claris Teng, Min Jun, Patrizia Natale, Marinella Ruospo, Valeria Saglimbene, Michel Jadoul, Wolfgang C. Winkelmayer, Kathleen Conn, Danielle Green, Tanya Green, and John Davis. The development and publication of this guideline were supported by KDIGO. The opinions or views expressed in this summary are those of the authors and do not necessarily reflect the opinions or recommendations of the International Society of Nephrology or Elsevier. Dosages, indications, and methods of use for products that are referred to by the authors may reflect their clinical experience or may be derived from the professional literature or other clinical sources.

Funding Information:
IHdB declared having received consultancy fees from Boehringer Ingelheim, Cyclerion Therapeutics, George Clinical, Goldfinch Bio, and Ironwood; and research support from Abbott ∗ and Medtronic. ∗ MLC declared having received consultancy fees from AstraZeneca, Bayer, ∗ Boehringer Ingelheim, and Gilead; research support from Bayer ∗ and Novartis ∗ ; and speaker honoraria from Bayer. ∗ JCNC is a board member of Asia Diabetes Foundation. She has declared having received consultancy fees from AstraZeneca, ∗ Bayer, ∗ Boehringer Ingelheim, ∗ Merck Sharp & Dohme, ∗ Novartis, ∗ and Sanofi ∗ ; research support from AstraZeneca, ∗ Eli Lilly and Company, ∗ Merck, ∗ Pfizer, ∗ and Sanofi ∗ ; and speaker honoraria from Boehringer Ingelheim, ∗ Merck Sharp & Dohme, ∗ Novartis, ∗ and Sanofi. ∗ She has given educational presentations for Boehringer Ingelheim ∗ and is the founding director and shareholder of a startup biogenetic testing company GEMVCARE, with partial support by the Hong Kong Government. HJLH declaring having received consultancy fees from Abbvie, ∗ Astellas, ∗ AstraZeneca, ∗ Bayer, Boehringer Ingelheim, ∗ CSL Pharma, ∗ Chinook, Fresenius Medical Care, ∗ Gilead, ∗ Goldfinch Bio, Janssen, ∗ Merck, ∗ Mundipharma, Mitsubishi Tanabe, ∗ and Retrophin; and research support from Abbvie, ∗ AstraZeneca, ∗ Boehringer Ingelheim, ∗ and Janssen. ∗ KK declared having received consultancy fees from Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly and Company, Janssen, Merck Sharp & Dohme, Novartis, Novo Nordisk, Roche, Sanofi, and Servier; speaker honoraria from Amgen, AstraZeneca, Berlin-Chemie AG/Menarini Group, Boehringer Ingelheim, Eli Lilly and Company, Janssen, Merck Sharp & Dohme, Napp, Novartis, Novo Nordisk, Roche, and Sanofi; and research support from AstraZeneca, ∗ Boehringer Ingelheim, ∗ Eli Lilly and Company, ∗ Janssen, ∗ Merck Sharp & Dohme, ∗ Novartis, ∗ Novo Nordisk, ∗ Roche, ∗ and Sanofi. ∗ KK receives general support from the National Institute for Health Research (NIHR) Applied Research Collaboration East Midlands (ARC EM), and the NIHR Leicester Biomedical Research Centre (BRC). AL declared having received consultancy fees from Alnylam, DaVita, and George Clinical; and speaker honoraria from Baxter. SDN declared having received consultancy fees from Bayer, Boehringer Ingelheim, Reata, and Tricida; and research support from Keryx. NT declared having received research support from the Global Alliance for Chronic Diseases-Indian Council of Medical Research, the Government of India; the Indian Council of Medical Research; National Heart, Lung, and Blood Institute/National Institutes of Health, and Novo Nordisk. KRT declared having received consultancy fees from AstraZeneca, Boehringer Ingelheim, Eli Lilly and Company, Gilead, Goldfinch Bio, and Novo Nordisk; research support from Goldfinch Bio ∗ ; and speaker honoraria from AstraZeneca, Eli Lilly and Company, Gilead, Goldfinch Bio, and Janssen. CW is a board member of Bayer, Boehringer Ingelheim, Genzyme-Sanofi, Gilead, GlaxoSmithKline, Merck Sharp & Dohme, and Tricida; he has declared having received consultancy fees from Akebia, Fresenius Medical Care, Reata, and Vifor Fresenius Medical Care Renal Pharma; and speaker honoraria from AstraZeneca, B. Braun, Boehringer Ingelheim, Eli Lilly and Company, Fresenius Medical Care, Genzyme-Sanofi, Merck Sharp & Dohme, Novartis, and Shire. SZ is an advisory board member of AstraZeneca, ∗ Boehringer Ingelheim, ∗ Merck Sharp & Dohme Australia, ∗ Novo Nordisk, ∗ and Sanofi ∗ ; she has declared having received speaker honoraria from Servier Laboratories Australia ∗ ; and served on expert committee at Eli Lilly Australia Ltd. ∗ MT declared having received speaker honoraria from B. Braun. † PR declared having received consultancy fees from Abbvie, ∗ Astellas, ∗ AstraZeneca, ∗ Bayer, ∗ Boehringer Ingelheim, ∗ Gilead, ∗ and Novo Nordisk ∗ ; research support from AstraZeneca ∗ and Novo Nordisk ∗ ; and speaker honoraria from AstraZeneca, ∗ Boehringer Ingelheim, ∗ Eli Lily and Company, ∗ and Novo Nordisk ∗ ; he has given an educational presentation for Merck ∗ ∗ † ; and has stock/stock options in Novo Nordisk. All the other authors declared no competing interests.

Publisher Copyright:
© 2020 KDIGO

Keywords

  • GLP-1 receptor agonist
  • HbA1c
  • KDIGO
  • SGLT2 inhibitor
  • angiotensin II receptor blocker
  • angiotensin-convering enzyme inhibitor
  • chronic kidney disease
  • dialysis
  • evidence-based
  • glycemia
  • glycemic monitoring
  • glycemic targets
  • guideline
  • hemodialysis
  • lifestyle
  • metformin
  • models of care
  • nutrition
  • renin-angiotensin system
  • self-management
  • systematic review
  • team-based care

PubMed: MeSH publication types

  • Practice Guideline

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