KDIGO and related kidney guidelines.

7 topics · 9 versions · 2 high-yield

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Acute kidney injury ⭐

aki · society: KDIGO · high-yield

KDIGO’s 2012 guideline establishes a unified definition and staging system for acute kidney injury (AKI) by merging RIFLE and AKIN criteria, and provides evidence-graded recommendations for risk assessment, prevention, pharmacologic management, contrast-induced AKI (CI-AKI), and renal replacement therapy (RRT). It emphasizes early recognition, hemodynamic optimization with crystalloids, avoidance of nephrotoxins, and stage-based management. Specific guidance is given for RRT timing, modality, anticoagulation, vascular access, dose, and buffer choice.

Blood pressure in CKD

bp-in-ckd · society: KDIGO

Update to the 2012 KDIGO BP guideline covering BP measurement, lifestyle interventions, antihypertensive therapy in CKD (with/without diabetes), kidney transplant recipients, and children. Major changes from 2012: emphasis on standardized office BP measurement, lower SBP target of <120 mm Hg for most adults with non-dialysis CKD (largely from SPRINT), and a unified target irrespective of diabetes, proteinuria, or older age. Renin-angiotensin system inhibitors remain first-line for CKD with albuminuria; dual RAS blockade is to be avoided.

Chronic kidney disease ⭐

ckd · society: KDIGO · high-yield

KDIGO 2024 updates the 2012 CKD guideline with major changes including endorsement of eGFRcr-cys (creatinine + cystatin C) for accurate staging, race-free GFR estimation, validated risk equations (KFRE) to drive referral and modality decisions, and strong recommendations for SGLT2 inhibitors across diabetic and non-diabetic CKD. New emphasis on a holistic, multi-drug treatment paradigm (RASi + SGLT2i + statin + nonsteroidal MRA in T2D), risk-based rather than eGFR-only management, and structured drug stewardship/imaging guidance. Scope covers adults and children with non-dialysis, non-transplant CKD.

CKD-mineral & bone disorder

ckd-mbd · society: KDIGO

Selective update of the 2009 KDIGO CKD-MBD guideline addressing diagnosis and treatment of mineral and bone disorders in CKD G3a–G5D and kidney transplant recipients. Key revisions: BMD testing is now recommended (rather than discouraged) because newer cohort data show DXA predicts fracture in CKD; phosphate-lowering therapy is reserved for overt/progressive hyperphosphatemia rather than preventive normalization; calcium-based phosphate binders should be restricted across all CKD stages (not only with hypercalcemia); routine calcitriol/vitamin D analogs are not recommended in CKD G3a–G5 non-dialysis due to hypercalcemia risk; and calcimimetics, calcitriol, or vitamin D analogs are all acceptable first-line PTH-lowering options in CKD G5D.

Diabetes in CKD

diabetes-in-ckd · society: KDIGO

KDIGO 2022 is a focused update of the 2020 guideline on diabetes management in CKD, with major revisions to Chapter 1 (comprehensive care) and Chapter 4 (glucose-lowering therapies in T2D); chapters on glycemic monitoring/targets, lifestyle, and care delivery remain unchanged. Key updates expand SGLT2i use down to eGFR ≥20 ml/min/1.73 m² and add a new recommendation for nonsteroidal MRA (finerenone) in T2D with albuminuria despite maximally tolerated RAS inhibition. The guideline emphasizes a layered comprehensive approach: lifestyle therapy plus first-line metformin + SGLT2i + RAS inhibitor + statin, with GLP-1 RA and ns-MRA added based on residual risk.

Glomerular diseases

glomerular-diseases · society: KDIGO

KDIGO 2021 updates the 2012 glomerulonephritis guideline, covering IgA nephropathy/vasculitis, membranous nephropathy, nephrotic syndrome in children, MCD and FSGS in adults, infection-related GN, MPGN/C3 glomerulopathy, ANCA vasculitis, lupus nephritis, and anti-GBM disease. New features include practice points (consensus guidance where evidence is insufficient), risk-stratified treatment for MN, expanded role of rituximab, and recognition that anti-PLA2R serology can diagnose MN without biopsy. Treatment paradigms shift toward minimizing glucocorticoid exposure and individualized risk-based immunosuppression.

Hyponatremia

hyponatremia

Compilation review comparing the 2013 US expert panel and 2014 European hyponatremia guidelines on diagnosis and treatment of hyponatremia (SNa <136 mmol/L). Both guidelines converge on bolus hypertonic saline for acute/symptomatic hyponatremia and fluid restriction as first-line for chronic hyponatremia, but diverge on diagnostic algorithm (European prioritizes urine osmolality/sodium over volume status), pharmacologic second-line therapy for SIAD, correction-rate limits, and use of vaptans (US permits; European recommends against in profound hyponatremia). Emerging diagnostic markers include fractional uric acid excretion and plasma copeptin.

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