• Sankar D Navaneethan, Sophia Zoungas, M Luiza Caramori, Chan Juliana C N JCN 0000-0003-1325-1194 Hong Kong Institute of Diabetes and Obesity and Li Ka Shing Institute of Health Science, The Chinese Universi, Hiddo J L Heerspink, Clint Hurst, Adrian Liew, Erin D Michos, Wasiu A Olowu, Tami Sadusky, Nikhil Tandon, Katherine R Tuttle, Christoph Wanner, Katy G Wilkens, Lyubov Lytvyn, Jonathan C Craig, David J Tunnicliffe, Martin Howell, Marcello Tonelli, Michael Cheung, Amy Earley, Peter Rossing, Ian H de Boer, and Kamlesh Khunti.
• 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.).
• Ann. Intern. Med. 2021 Mar 1; 174 (3): 385-394.

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).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.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.

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