February 7, 2022, New York, NY — Today, the latest guideline for managing diabetes in patients with kidney disease has been endorsed by the National Kidney Foundation’s (NKF) professional workgroup charged with reviewing the “KDIGO 2020 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease.”
Led by co-chairs Drs. Amy Mottl and Susanne Nicholas, the team of physicians reviewed the Kidney Disease Improving Global Outcomes (KDIGO) recommendations over the last 10 months and will release today their commentary on the guidelines in the American Journal of Kidney Diseases. KDIGO is a nonprofit, international organization that works to improve the care and outcomes of patients with kidney disease through the development of clinical practice guidelines. NKF’s Kidney Disease Outcomes Quality Initiative (KDOQI), in addition to producing its own evidence-based guidelines for US practitioners, reviews KDIGO guidelines for applicability in US practice.
The KDOQI commentary was highly supportive of the new 2020 KDIGO recommended treatment guidelines. The workgroup was particularly pleased that in addition to addressing the emergence of SGLT2 inhibitors as a treatment for diabetic kidney disease and the nuances of renin-angiotensin system inhibition, KDIGO provided a thorough review and recommendations on comprehensive management of nutrition, exercise, and multidisciplinary collaboration as a central component of care.
“The discovery of multiple, effective therapies for diabetic kidney disease has brought about renewed hope and a transformative change for the care of patients,” said KDOQI workgroup co-chair Amy K. Mottl, MD MPH FASN, Associate Professor of Medicine, UNC Division of Nephrology and Hypertension, Chapel Hill, N.C. “This has reinvigorated the diabetes community to explore optimal approaches to clinical care, education of patients and providers, and to carry on in the quest for individualized treatments at all stages of kidney disease. There is still much to be done in the realms of research, public policy, and education, but this renewed energy, together with dedication and continued collaboration, will hopefully bring about a day when end-stage kidney disease from diabetes is a rarity.”
“KDIGO is to be commended for the development of their first guideline on the management of diabetes mellitus in chronic kidney disease”, said Michael V. Rocco, MD, MSCE, KDOQI chair and the Vardaman M. Buckalew Jr. Professor of Medicine at the Wake Forest School of Medicine in Winston-Salem, NC. “The incorporation of recently published results from randomized clinical trials of SGLT2 inhibitors and long-acting GLP-1RAs will be invaluable to clinicians navigating the care of kidney disease patients in this rapidly changing field. These clinical trials build upon the work done by the National Kidney Foundation, in partnership with the Food and Drug Administration, to develop new surrogate endpoints for clinical trials in patients with chronic kidney disease.”
The KDIGO Commentary chose to use the terminology “diabetes and chronic kidney disease” rather than “diabetic kidney disease.” The KDOQI workgroup thought this might create confusion over individuals with known nondiabetic kidney disease versus individuals with probable diabetic glomerulosclerosis.
“We are at a pivotal moment in the care of people with diabetes and CKD,” the authors wrote. “Never before has there been so much attention paid and resources provided to this important disease state. While many challenges remain in this field, KDIGO has made a significant step forward in providing a comprehensive clinical practice guideline dedicated to diabetes and CKD.”
“There is much work to be done to improve the health and quality of life for patients with diabetes and CKD, but KDIGO has now provided a platform from which the research, policy and clinical communities can unite to make further impactful changes.” Dr. Mottl said.
To learn more about the commentary and the workgroup participants, www.ajkd.org/article/S0272-6386(21)00924-0/fulltext
Kidney Disease Facts
In the United States, 37 million adults are estimated to have chronic kidney disease (CKD)—and approximately 90 percent don’t know they have it. 1 in 3 adults in the U.S. is at risk for chronic kidney disease. Risk factors for kidney disease include: diabetes, high blood pressure, heart disease, obesity, and family history. People who are Black or African American, Hispanic or Latino, American Indian or Alaska Native, Asian American, or Native Hawaiian or Other Pacific Islander are at increased risk for developing the disease. Black or African American people are almost 4 times more likely than Whites to have kidney failure. Hispanic or Latino people are 1.3 times more likely than non-Hispanic or non-Latino people to have kidney failure.
About the National Kidney Foundation
The National Kidney Foundation (NKF) is the largest, most comprehensive, and longstanding patient-centric organization dedicated to the awareness, prevention, and treatment of kidney disease in the U.S. For more information about NKF, visit www.kidney.org.
About the American Journal of Kidney Diseases
The American Journal of Kidney Diseases (AJKD), the official journal of the National Kidney Foundation, is recognized worldwide as a leading source of information devoted to clinical nephrology practice and clinical research. Articles selected for publication in AJKD undergo a rigorous consideration process, supporting the journal's goal to communicate important new information in clinical nephrology in a way that strengthens knowledge and helps physicians to provide their patients with the highest standard of care.