Diabetes Management in Chronic Kidney Disease: Synopsis of the 2020 KDIGO Clinical Practice Guideline

The Kidney Disease: Improving Global Outcomes (KDIGO) organization developed a clinical practice guideline in 2020 for the management of patients with diabetes and chronic kidney disease (CKD). The KDIGO Work Group (WG) was tasked with developing the guideline for diabetes management in CKD. It defi...

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Published in:	Annals of internal medicine Vol. 174; no. 3; p. 385
Main Authors:	Navaneethan, Sankar D, Zoungas, Sophia, Caramori, M Luiza, Chan, Juliana C N, Heerspink, Hiddo J L, Hurst, Clint, Liew, Adrian, Michos, Erin D, Olowu, Wasiu A, Sadusky, Tami, Tandon, Nikhil, Tuttle, Katherine R, Wanner, Christoph, Wilkens, Katy G, Lytvyn, Lyubov, Craig, Jonathan C, Tunnicliffe, David J, Howell, Martin, Tonelli, Marcello, Cheung, Michael, Earley, Amy, Rossing, Peter, de Boer, Ian H, Khunti, Kamlesh
Format:	Journal Article
Language:	English
Published:	United States 01.03.2021
Subjects:	Diabetes Mellitus, Type 1 - complications Diabetes Mellitus, Type 1 - therapy Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - therapy Humans Renal Insufficiency, Chronic - complications Renal Insufficiency, Chronic - therapy
ISSN:	1539-3704, 1539-3704
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Abstract	The Kidney Disease: Improving Global Outcomes (KDIGO) organization developed a clinical practice guideline in 2020 for the management of patients with diabetes and chronic kidney disease (CKD). The KDIGO Work Group (WG) was tasked with developing the guideline for diabetes management in CKD. It defined the scope of the guideline, gathered evidence, determined systematic review topics, and graded evidence that had been summarized by an evidence review team. The English-language literature searches, which were initially done through October 2018, were updated in February 2020. The WG used the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to appraise evidence and rate the strength of the recommendations. Expert judgment was used to develop consensus practice points supplementary to the evidence-based graded recommendations. The guideline document underwent open public review. Comments from various stakeholders, subject matter experts, and industry and national organizations were considered before the document was finalized. The guideline includes 12 recommendations and 48 practice points for clinicians caring for patients with diabetes and CKD. This synopsis focuses on the key recommendations pertinent to the following issues: comprehensive care needs, glycemic monitoring and targets, lifestyle interventions, antihyperglycemic therapies, and educational and integrated care approaches.
AbstractList	The Kidney Disease: Improving Global Outcomes (KDIGO) organization developed a clinical practice guideline in 2020 for the management of patients with diabetes and chronic kidney disease (CKD).DESCRIPTIONThe Kidney Disease: Improving Global Outcomes (KDIGO) organization developed a clinical practice guideline in 2020 for the management of patients with diabetes and chronic kidney disease (CKD).The KDIGO Work Group (WG) was tasked with developing the guideline for diabetes management in CKD. It defined the scope of the guideline, gathered evidence, determined systematic review topics, and graded evidence that had been summarized by an evidence review team. The English-language literature searches, which were initially done through October 2018, were updated in February 2020. The WG used the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to appraise evidence and rate the strength of the recommendations. Expert judgment was used to develop consensus practice points supplementary to the evidence-based graded recommendations. The guideline document underwent open public review. Comments from various stakeholders, subject matter experts, and industry and national organizations were considered before the document was finalized.METHODSThe KDIGO Work Group (WG) was tasked with developing the guideline for diabetes management in CKD. It defined the scope of the guideline, gathered evidence, determined systematic review topics, and graded evidence that had been summarized by an evidence review team. The English-language literature searches, which were initially done through October 2018, were updated in February 2020. The WG used the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to appraise evidence and rate the strength of the recommendations. Expert judgment was used to develop consensus practice points supplementary to the evidence-based graded recommendations. The guideline document underwent open public review. Comments from various stakeholders, subject matter experts, and industry and national organizations were considered before the document was finalized.The guideline includes 12 recommendations and 48 practice points for clinicians caring for patients with diabetes and CKD. This synopsis focuses on the key recommendations pertinent to the following issues: comprehensive care needs, glycemic monitoring and targets, lifestyle interventions, antihyperglycemic therapies, and educational and integrated care approaches.RECOMMENDATIONSThe guideline includes 12 recommendations and 48 practice points for clinicians caring for patients with diabetes and CKD. This synopsis focuses on the key recommendations pertinent to the following issues: comprehensive care needs, glycemic monitoring and targets, lifestyle interventions, antihyperglycemic therapies, and educational and integrated care approaches. The Kidney Disease: Improving Global Outcomes (KDIGO) organization developed a clinical practice guideline in 2020 for the management of patients with diabetes and chronic kidney disease (CKD). The KDIGO Work Group (WG) was tasked with developing the guideline for diabetes management in CKD. It defined the scope of the guideline, gathered evidence, determined systematic review topics, and graded evidence that had been summarized by an evidence review team. The English-language literature searches, which were initially done through October 2018, were updated in February 2020. The WG used the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to appraise evidence and rate the strength of the recommendations. Expert judgment was used to develop consensus practice points supplementary to the evidence-based graded recommendations. The guideline document underwent open public review. Comments from various stakeholders, subject matter experts, and industry and national organizations were considered before the document was finalized. The guideline includes 12 recommendations and 48 practice points for clinicians caring for patients with diabetes and CKD. This synopsis focuses on the key recommendations pertinent to the following issues: comprehensive care needs, glycemic monitoring and targets, lifestyle interventions, antihyperglycemic therapies, and educational and integrated care approaches.
Author	Wanner, Christoph Heerspink, Hiddo J L Sadusky, Tami Lytvyn, Lyubov Howell, Martin Zoungas, Sophia Olowu, Wasiu A Tonelli, Marcello Chan, Juliana C N Khunti, Kamlesh Hurst, Clint de Boer, Ian H Caramori, M Luiza Tandon, Nikhil Tunnicliffe, David J Earley, Amy Wilkens, Katy G Cheung, Michael Tuttle, Katherine R Michos, Erin D Craig, Jonathan C Liew, Adrian Rossing, Peter Navaneethan, Sankar D
Author_xml	– sequence: 1 givenname: Sankar D surname: Navaneethan fullname: Navaneethan, Sankar D organization: Section of Nephrology and Institute of Clinical and Translational Research, Baylor College of Medicine, and Michael E. DeBakey VA Medical Center, Houston, Texas (S.D.N.) – sequence: 2 givenname: Sophia orcidid: 0000-0003-2672-0949 surname: Zoungas fullname: Zoungas, Sophia organization: Monash University, School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia (S.Z.) – sequence: 3 givenname: M Luiza surname: Caramori fullname: Caramori, M Luiza organization: University of Minnesota, Minneapolis, Minnesota (M.L.C.) – sequence: 4 givenname: Juliana C N orcidid: 0000-0003-1325-1194 surname: Chan fullname: Chan, Juliana C N organization: Hong Kong Institute of Diabetes and Obesity and Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Hong Kong, China (J.C.C.) – sequence: 5 givenname: Hiddo J L orcidid: 0000-0002-3126-3730 surname: Heerspink fullname: Heerspink, Hiddo J L organization: University of Groningen and University Medical Center, Groningen, the Netherlands (H.J.H.) – sequence: 6 givenname: Clint surname: Hurst fullname: Hurst, Clint organization: Houston, Texas (C.H.) – sequence: 7 givenname: Adrian orcidid: 0000-0002-0963-6270 surname: Liew fullname: Liew, Adrian organization: Mount Elizabeth Novena Hospital, Singapore (A.L.) – sequence: 8 givenname: Erin D orcidid: 0000-0002-5547-5084 surname: Michos fullname: Michos, Erin D organization: Johns Hopkins University School of Medicine, Baltimore, Maryland (E.D.M.) – sequence: 9 givenname: Wasiu A surname: Olowu fullname: Olowu, Wasiu A organization: Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun, Nigeria (W.A.O.) – sequence: 10 givenname: Tami surname: Sadusky fullname: Sadusky, Tami organization: Seattle, Washington (T.S.) – sequence: 11 givenname: Nikhil orcidid: 0000-0003-4604-1986 surname: Tandon fullname: Tandon, Nikhil organization: All India Institute of Medical Sciences, New Delhi, India (N.T.) – sequence: 12 givenname: Katherine R orcidid: 0000-0002-2235-0103 surname: Tuttle fullname: Tuttle, Katherine R organization: University of Washington, Spokane, Washington (K.R.T.) – sequence: 13 givenname: Christoph surname: Wanner fullname: Wanner, Christoph organization: University Hospital of Würzburg, Würzburg, Germany (C.W.) – sequence: 14 givenname: Katy G orcidid: 0000-0002-1281-4541 surname: Wilkens fullname: Wilkens, Katy G organization: Northwest Kidney Centers, Seattle, Washington (K.G.W.) – sequence: 15 givenname: Lyubov surname: Lytvyn fullname: Lytvyn, Lyubov organization: MAGIC Evidence Ecosystem Foundation, McMaster University, Hamilton, Ontario, Canada (L.L.) – sequence: 16 givenname: Jonathan C surname: Craig fullname: Craig, Jonathan C organization: College of Medicine and Public Health, Flinders University, and Cochrane Kidney and Transplant, Adelaide, Australia (J.C.C.) – sequence: 17 givenname: David J surname: Tunnicliffe fullname: Tunnicliffe, David J organization: School of Public Health, The University of Sydney, and Cochrane Kidney and Transplant, Sydney, Australia (D.J.T., M.H.) – sequence: 18 givenname: Martin surname: Howell fullname: Howell, Martin organization: School of Public Health, The University of Sydney, and Cochrane Kidney and Transplant, Sydney, Australia (D.J.T., M.H.) – sequence: 19 givenname: Marcello orcidid: 0000-0002-0846-3187 surname: Tonelli fullname: Tonelli, Marcello organization: University of Calgary, Calgary, Alberta, Canada (M.T.) – sequence: 20 givenname: Michael surname: Cheung fullname: Cheung, Michael organization: KDIGO, Brussels, Belgium (M.C., A.E.) – sequence: 21 givenname: Amy orcidid: 0000-0003-3200-2492 surname: Earley fullname: Earley, Amy organization: KDIGO, Brussels, Belgium (M.C., A.E.) – sequence: 22 givenname: Peter orcidid: 0000-0002-1531-4294 surname: Rossing fullname: Rossing, Peter organization: Steno Diabetes Center and University of Copenhagen, Copenhagen, Denmark (P.R.) – sequence: 23 givenname: Ian H orcidid: 0000-0003-1571-7592 surname: de Boer fullname: de Boer, Ian H organization: University of Washington, Kidney Research Institute, Seattle, Washington (I.H.D.) – sequence: 24 givenname: Kamlesh surname: Khunti fullname: Khunti, Kamlesh organization: Diabetes Research Centre, University of Leicester, and Leicester General Hospital, Leicester, United Kingdom (K.K.)
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SubjectTerms	Diabetes Mellitus, Type 1 - complications Diabetes Mellitus, Type 1 - therapy Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - therapy Humans Renal Insufficiency, Chronic - complications Renal Insufficiency, Chronic - therapy
Title	Diabetes Management in Chronic Kidney Disease: Synopsis of the 2020 KDIGO Clinical Practice Guideline
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