Interpretation of Diabetes Management in Chronic Kidney Disease: a Consensus Report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO)

Abstract

People with diabetes and chronic kidney disease (CKD) are at high risk for kidney failure, atherosclerotic cardiovascular disease, heart failure, and premature mortality. The American Diabetes Association (ADA) and the Kidney Disease: Improving Global Outcomes (KDIGO) established joint group, and integration of evidence-based recommendations for diabetes management in patients with CKD in accordance with the ADA 2022 standards of medical care in diabetes and KDIGO 2022 Clinical Practice Guideline for Diabetes Management in CKD, and to form the Diabetes Management in Chronic Kidney Disease: a Consensus Report by the ADA and KDIGO. The consensus not only re-emphasizes the published guidelines for screening and diagnosis of CKD, glycemia monitoring, lifestyle therapies, treatment goals, and pharmacologic management, but also specifically emphasizes the importance of comprehensive care in which pharmacotherapy based on a foundation of healthy lifestyle. The consensus states seven core recommendations which provide specific guidance for the use of renin-angiotensin system inhibitors, metformin, sodium-glucose cotransporter-2 inhibitors, glucagon-like peptide 1 receptor agonists, and a nonsteroidal mineral corticoid receptor antagonist. These areas of consensus provide clear direction for implementation of care to improve clinical outcomes of people with diabetes and CKD. Focusing on the main contents of the consensus, we interpreted main recommendations in order to provide concise and practical guidance for clinicians, to achieve the goal of improving the prognosis of patients with diabetes mellitus complicated with CKD.

Keywords

• chronic kidney diseases|diabetes mellitus|glycemic control|diagnosis|drug therapy|guide interpretation