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Clinical practice guidelines

TL;DR — KDIGO 2024 is the global umbrella guideline for CKD evaluation, classification, progression and complications (KDIGO CKD Work Group 2024, PMID 38490803) (Levin 2024, PMID 38519239). It is supplemented by topic guidelines for blood pressure, diabetes, anaemia, CKD-MBD, nutrition and lipids (Cheung 2021, PMID 33637203) (Rossing 2022, PMID 36272755) (Babitt 2026, PMID 41485807) (Ketteler 2017, PMID 28646995) (Ikizler 2020, PMID 32829751) (Tonelli 2014, PMID 24323134). NICE NG203 and the Australian CKD handbook translate evidence into national detection and referral systems; implementation details differ with formularies and service capacity. Both are web-published rather than journal-indexed, so they carry URLs and access dates in the registry rather than PMIDs. Guideline recommendations must be read alongside evidence date: several drug classes changed the field faster than guideline cycles.

Guideline architecture

KDIGO uses GRADE recommendations plus practice points; not every practice point rests on a systematic review. The full registry records current and superseded documents.

Evaluation and risk

KDIGO 2024 centers cause-GFR-albuminuria classification and incorporates validated kidney-failure risk into referral and planning (KDIGO CKD Work Group 2024, PMID 38490803).

Drug layering

KDIGO diabetes guidance integrated SGLT2 inhibitors and non-steroidal MRA evidence through 2022 (Rossing 2022, PMID 36272755). The lag has since widened: FLOW (2024), CONFIDENCE (2025), FINE-ONE and FIND-CKD (2026) and the INFINITY pooled analysis (2026) all post-date that cycle, and FIND-CKD in particular takes finerenone outside diabetes altogether (Perkovic 2024, PMID 38785209) (Agarwal 2025, PMID 40470996) (Heerspink 2026, PMID 41780000) (Heerspink 2026, PMID 42246672) (Neuen 2026, PMID 42248158).

Blood pressure border

KDIGO 2021 provides the BP guideline (Cheung 2021, PMID 33637203); this condition interprets its kidney consequences while hypertension owns measurement and target synthesis.

Complications

KDIGO MBD 2017 emphasizes serial integrated biochemistry (Ketteler 2017, PMID 28646995); the 2026 anaemia update is now the current global anaemia document (Babitt 2026, PMID 41485807).

Disagreements

Universal versus risk-based screening, referral thresholds, cystatin C access, nutrition detail and formulary-specific drug positioning vary across bodies and regions. A further disagreement is now dated rather than conceptual: no current guideline in this registry was written after the 2026 non-diabetic finerenone evidence, so guidance restricting non-steroidal MRA to diabetic CKD reflects its evidence cycle rather than the current trial base (Heerspink 2026, PMID 42246672) (Neuen 2026, PMID 42248158).

Current guideline map

Body Document Evidence date / publication CKD role
KDIGO Evaluation and Management of CKD 2024 Global umbrella guideline (KDIGO CKD Work Group 2024, PMID 38490803)
KDIGO Blood Pressure in CKD 2021 BP process and targets (Cheung 2021, PMID 33637203)
KDIGO Diabetes Management in CKD 2022 SGLT2 and non-steroidal MRA integration (Rossing 2022, PMID 36272755)
KDIGO Anaemia in CKD 2026 Current anaemia framework (Babitt 2026, PMID 41485807)
KDIGO CKD-MBD 2017 update Serial integrated biochemical interpretation (Ketteler 2017, PMID 28646995)
KDOQI Nutrition in CKD 2020 Detailed nutrition recommendations (Ikizler 2020, PMID 32829751)
NICE NG203 Published 25 Aug 2021; updated 24 Nov 2021; reviewed 19 Aug 2025 UK detection, referral and management pathway
Kidney Health Australia CKD Management in Primary Care, 5th ed. Edition year not stated on the publisher's page (accessed 2026-09-02) Australian primary-care implementation

A new joint guideline has changed the map

The most consequential guideline development since KDIGO 2024 is not a nephrology document. The 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome retires, replaces and expands the 2013 AHA/ACC/TOS obesity guideline, and explicitly addresses the interconnections between metabolic risk factors (obesity, type 2 diabetes), CKD and cardiovascular disease. Its literature search ran from 29 October 2024 to 14 April 2025 across MEDLINE, EMBASE, the Cochrane Library, AHRQ and other databases for human studies published since 2015, and it is framed as a living document intended for cardiologists, endocrinologists, nephrologists and primary care alike (Ndumele 2026, PMID 42263157; also published as PMID 42265997).

Three structural consequences follow for anyone reading CKD guidance.

  1. Sponsorship changes the class-and-level system in use. ACC/AHA joint guidelines use Class of Recommendation and Level of Evidence; KDIGO uses GRADE recommendation strength (1/2) with evidence quality (A–D) plus ungraded "practice points". A KDIGO Grade 1A and an ACC/AHA Class 1, Level A are not the same claim, and the two systems place different content in their ungraded categories.
  2. Its evidence window closes in April 2025, which is later than KDIGO 2024 but still before CONFIDENCE (PMID 40470996), FINE-ONE (PMID 41780000), FIND-CKD (PMID 42246672) and the INFINITY pooled analysis (PMID 42248158). The dated-rather-than-conceptual disagreement recorded below therefore persists even under the newest document.
  3. ASN co-authorship means the nephrology position is now embedded in a cardiology-led document, which reduces the risk of the divergent-recommendation problem that the CKM advisory identified as needing "harmonization across major subspecialty guidelines" (Ndumele 2023, PMID 37807924).

The diabetes-specific counterpart is updated annually rather than on a multi-year cycle: ADA Standards of Care in Diabetes Section 11, "Chronic Kidney Disease and Risk Management", carries its own evidence-grading system and is revised at least yearly by the ADA Professional Practice Committee (American Diabetes Association Professional Practice Committee 2026, PMID 41358881). Annual revision is the single most important structural difference between the ADA document and every other guideline in this registry, and it is why ADA guidance typically incorporates new kidney-outcome trials one to three years ahead of KDIGO.

Cycle length as a source of disagreement

Body Document Grading system Revision cadence Evidence horizon
KDIGO CKD Evaluation and Management 2024 (PMID 38490803) GRADE 1/2 × A–D, plus ungraded practice points Multi-year, topic-by-topic Pre-2024
AHA/ACC/ADA/ASN CKM Syndrome 2026 (PMID 42263157) ACC/AHA Class of Recommendation × Level of Evidence Declared "living" Search closed April 2025
ADA Standards of Care §11, annual (PMID 41358881) ADA A/B/C/E grading Annual or more often Most current of the three
NICE NG203, summarised for practitioners (Martinez 2021, PMID 34489303) NICE evidence-to-recommendation, cost-effectiveness explicit Surveillance-triggered review 2021, reviewed 2025

The practical instruction that follows is to read every recommendation with two dates attached — the publication date and the evidence-search closing date — and to treat the gap between them as the minimum lag. For CKM 2026 that gap is about ten months; for a KDIGO topic guideline at the end of its cycle it can exceed five years.

Where the bodies actually differ

Beyond the dating problem, the substantive disagreements are these, and each traces to a defensible difference in what the body is optimising.

  • Universal versus risk-based screening. NICE frames detection through explicit cost-effectiveness within a single-payer system (Martinez 2021, PMID 34489303); the US modelling literature reaches favourable ICERs for population albuminuria screening at $86,300–$128,400 per QALY under US prices and SGLT2 inhibitor efficacy (Cusick 2023, PMID 37216661; Cusick 2024, PMID 39514193). The disagreement is about willingness-to-pay thresholds and drug prices, not about the biology.
  • Cystatin C. Its use as a confirmatory test is recommended where available, but availability is the binding constraint, and the accuracy case for the combined equation is strongest precisely in the discordant cases that a resource-constrained system is least likely to test (Fu 2023, PMID 36995139).
  • Non-steroidal MRA outside diabetes. No document in this registry was written after the 2026 non-diabetic finerenone evidence, so any restriction of finerenone to diabetic CKD reflects an evidence cycle rather than the current trial base (Heerspink 2026, PMID 42246672) (Neuen 2026, PMID 42248158).
  • Which risk equation to quote. PREVENT places eGFR inside cardiovascular risk prediction and is now multinationally validated (Khan 2024, PMID 37947085) (Neuen 2026, PMID 42086979), while KFRE remains the kidney-failure instrument (Tangri 2016, PMID 26757465). No guideline specifies which number to give a patient first.

The lipid guideline that abandoned targets

KDIGO's 2013 lipid guideline is the clearest example in this registry of a guideline whose central move was to remove a recommendation. Thirteen recommendations structure management as assessment in all, treatment in many, and follow-up measurement in few. The key positive recommendation is statin or statin/ezetimibe treatment in adults aged 50 or over with eGFR below 60 not on chronic dialysis and not transplanted. In dialysis patients, the Work Group noted that any relative risk reduction appears substantially smaller than at earlier CKD stages and did not recommend initiating statins in most prevalent haemodialysis patients (Wanner 2014, PMID 24552851).

The removal is the interesting part. Earlier guidelines set LDL-cholesterol targets, which require repeated measurement and escalate statin dose when unmet. KDIGO declined this because higher statin doses have not been shown to be safe in CKD, and because LDL level does not by itself indicate a need for dose escalation — so follow-up lipid measurement is not recommended (Wanner 2014, PMID 24552851). A "fire-and-forget" strategy justified explicitly by the absence of safety data for the alternative is unusual among guidelines and directly reflects the SHARP-versus-AURORA discontinuity described on the cardiovascular risk page.

This document also illustrates the cycle-length problem in its sharpest form: it is more than a decade old, it remains the KDIGO lipid guideline of record, and no document in this registry has revisited whether the dialysis recommendation should change in light of subsequent evidence.

Decision and interpretation matrix

Dimension Question Guardrail
Diagnostic axis Cause + G category + A category Avoid treating eGFR as the diagnosis
Time axis Chronicity and trajectory Separate acute change from persistent disease
Risk axis Kidney failure + cardiovascular events + death Show competing events
Treatment axis Eligibility, absolute benefit, harm, burden Do not rank drugs by relative effect alone
Measurement axis Assay, equation, repeatability State what was actually measured
Equity axis Testing, referral, access, affordability Audit downstream care, not labels only
Patient axis Symptoms, function, life participation Include outcomes patients prioritize
Evidence axis RCT, cohort, model, guideline Do not collapse designs

Evidence ledger

This ledger makes the page’s evidentiary mix inspectable. It does not imply that every source answers every question.

PMID Record used Role and boundary
38490803 KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. (KDIGO CKD Work Group 2024, PMID 38490803) Guideline or commentary; recommendation evidence depends on its review.
38519239 Executive summary of the KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease: known knowns and known unknowns. (Levin 2024, PMID 38519239) Guideline or commentary; recommendation evidence depends on its review.
33637203 Executive summary of KDIGO 2021 Blood Pressure in CKD guideline. (Cheung 2021, PMID 33637203) Guideline or commentary; recommendation evidence depends on its review.
36272755 Executive summary of KDIGO 2022 Diabetes Management in CKD guideline. (Rossing 2022, PMID 36272755) Guideline or commentary; recommendation evidence depends on its review.
41485807 Executive Summary of the KDIGO 2026 Clinical Practice Guideline for the Management of Anemia in Chronic Kidney Disease. (Babitt 2026, PMID 41485807) Guideline or commentary; recommendation evidence depends on its review.
28646995 Executive summary of the 2017 KDIGO Chronic Kidney Disease-Mineral and Bone Disorder Guideline Update. (Ketteler 2017, PMID 28646995) Guideline or commentary; recommendation evidence depends on its review.
32829751 KDOQI Clinical Practice Guideline for Nutrition in CKD: 2020 Update. (Ikizler 2020, PMID 32829751) Guideline or commentary; recommendation evidence depends on its review.
24323134 Lipid management in chronic kidney disease: synopsis of the KDIGO 2013 clinical practice guideline. (Tonelli 2014, PMID 24323134) Guideline or commentary; recommendation evidence depends on its review.
38785209 Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes. (Perkovic 2024, PMID 38785209) Intervention study; eligibility, comparator, endpoint and follow-up bound inference.
32061315 Global, regional, and national burden of chronic kidney disease, 1990-2017. (GBD CKD Collaboration 2020, PMID 32061315) Modelled projection; the estimate follows from the model inputs and assumptions, not from observed randomized follow-up.
22038337 A population-based approach for the definition of chronic kidney disease: CKD Prognosis Consortium. (Cirillo 2012, PMID 22038337) Synthesis; heterogeneity and included-study definitions constrain transport.
23243116 Cohort profile: the chronic kidney disease prognosis consortium. (Matsushita 2013, PMID 23243116) Observational or conceptual evidence; association is not treatment effect.
37787795 Estimated GFR, Albuminuria, and Adverse Outcomes: individual-participant data meta-analysis. (CKD Prognosis Consortium 2023, PMID 37787795) Synthesis; heterogeneity and included-study definitions constrain transport.
30348535 Relationship of Estimated GFR and Albuminuria to Concurrent Laboratory Abnormalities. (Inker 2019, PMID 30348535) Synthesis; heterogeneity and included-study definitions constrain transport.
34554658 New Creatinine- and Cystatin C-Based Equations to Estimate GFR without Race. (Inker 2021, PMID 34554658) Observational or conceptual evidence; association is not treatment effect.
34563581 A Unifying Approach for GFR Estimation: Recommendations of the NKF-ASN Task Force on Reassessing the Inclusion of Race in Diagnosing Kidney Disease. (Delgado 2022, PMID 34563581) Guideline or commentary; recommendation evidence depends on its review.
26757465 Multinational assessment of equations predicting kidney failure. (Tangri 2016, PMID 26757465) Synthesis; heterogeneity and included-study definitions constrain transport.
36857500 Kidney Failure Risk Equation evaluation with novel inputs in 59 cohorts. (Grams 2023, PMID 36857500) Observational or conceptual evidence; association is not treatment effect.
26028594 eGFR and albuminuria for prediction of cardiovascular outcomes: individual-participant meta-analysis. (Matsushita 2015, PMID 26028594) Synthesis; heterogeneity and included-study definitions constrain transport.
32970396 Dapagliflozin in Patients with Chronic Kidney Disease. (Heerspink 2020, PMID 32970396) Intervention study; eligibility, comparator, endpoint and follow-up bound inference.
36331190 Empagliflozin in Patients with Chronic Kidney Disease. (EMPA-KIDNEY Collaborative Group 2023, PMID 36331190) Intervention study; eligibility, comparator, endpoint and follow-up bound inference.
30990260 Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy. (Perkovic 2019, PMID 30990260) Intervention study; eligibility, comparator, endpoint and follow-up bound inference.
41205219 Chronic Kidney Disease Prevalence and Awareness Among US Adults. (Gong 2026, PMID 41205219) Observational or conceptual evidence; association is not treatment effect.
38213490 Cost-effectiveness of screening for chronic kidney disease: evidence and gaps. (van Mil 2024, PMID 38213490) Guideline or commentary; recommendation evidence depends on its review.
39137037 Screening for chronic kidney disease: change of perspective and novel developments. (van Mil 2024, PMID 39137037) Observational or conceptual evidence; association is not treatment effect.
38186904 Cost-effectiveness of screening for CKD in the general adult population: systematic review. (Yeo 2024, PMID 38186904) Synthesis; heterogeneity and included-study definitions constrain transport.
40227684 Balancing Efficiency and Equity in Population-Wide CKD Screening. (Cusick 2025, PMID 40227684) Modelled projection; the estimate follows from the model inputs and assumptions, not from observed randomized follow-up.
37403003 Chronic kidney disease of unknown aetiology: a global review. (Rao 2023, PMID 37403003) Observational or conceptual evidence; association is not treatment effect.
33116757 Mesoamerican Nephropathy: What We Know so Far. (Sanchez Polo 2020, PMID 33116757) Observational or conceptual evidence; association is not treatment effect.
18161745 Cellular and molecular mechanisms of fibrosis. (Wynn 2008, PMID 18161745) Observational or conceptual evidence; association is not treatment effect.
7246778 Hyperfiltration in remnant nephrons: a potentially adverse response to renal ablation. (Hostetter 1981, PMID 7246778) Observational or conceptual evidence; association is not treatment effect.
24522492 Relative risks of CKD for mortality and end-stage renal disease across races are similar. (Wen 2014, PMID 24522492) Observational or conceptual evidence; association is not treatment effect.
40470996 Finerenone with Empagliflozin in Chronic Kidney Disease and Type 2 Diabetes (CONFIDENCE). (Agarwal 2025, PMID 40470996) Intervention study; eligibility, comparator, endpoint and follow-up bound inference.
41780000 Finerenone in Type 1 Diabetes and Chronic Kidney Disease (FINE-ONE). (Heerspink 2026, PMID 41780000) Intervention study; eligibility, comparator, endpoint and follow-up bound inference.
42246672 Finerenone in Persons with Chronic Kidney Disease without Diabetes (FIND-CKD). (Heerspink 2026, PMID 42246672) Intervention study; eligibility, comparator, endpoint and follow-up bound inference.
42248158 Finerenone across CKD: individual participant data pooled analysis (INFINITY). (Neuen 2026, PMID 42248158) Synthesis; heterogeneity and included-study definitions constrain transport.

What can and cannot be concluded

  • Risk associations do not by themselves establish that changing the marker changes risk.
  • A relative effect must be paired with baseline risk, follow-up and the exact endpoint.
  • Albuminuria, acute eGFR change, chronic eGFR slope and kidney failure are not interchangeable.
  • Subgroup consistency is not evidence that every subgroup had adequate power.
  • Guideline recommendations combine evidence with values, feasibility, cost and service capacity.
  • Older adults require competing-mortality and treatment-burden framing.
  • Dialysis and transplantation comparisons are vulnerable to eligibility and immortal-time bias.
  • Modelled lifetime benefit is not a randomized observed benefit.
  • A biochemical response without a patient-important outcome remains a surrogate result.
  • This page is research synthesis, not individualized medical advice.

Research-design checklist

  • Define CKD cause, G category, A category and chronicity at baseline.
  • Report the creatinine or cystatin C equation and laboratory calibration.
  • Prespecify acute and chronic eGFR slopes when haemodynamic effects are expected.
  • Keep sustained GFR decline, kidney failure and replacement therapy separable.
  • Report absolute event risks, follow-up and confidence intervals with relative effects.
  • Treat death as a competing event where it can preclude kidney failure.
  • Measure hyperkalaemia, acute kidney injury and treatment discontinuation consistently.
  • Include symptoms, function, life participation and treatment burden.
  • Describe background RAS, SGLT2, MRA and GLP-1 therapy explicitly.
  • Prespecify albuminuria and cause strata without over-reading underpowered interactions.
  • Record screening, prescribing, persistence and monitoring as separate implementation steps.
  • Report representation, access and affordability variables needed for equity analysis.

Open questions

  • How should a guideline handle a drug class whose evidence base changes faster than its revision cycle? Finerenone moved outside diabetes after every guideline in this registry was written (Heerspink 2026, PMID 42246672) (Neuen 2026, PMID 42248158).
  • Should recommendations be graded on trial evidence alone, or explicitly on evidence plus feasibility, cost and service capacity? KDIGO already separates practice points from graded recommendations, without a standard for the separation (KDIGO CKD Work Group 2024, PMID 38490803) (Levin 2024, PMID 38519239).
  • Which of the disagreements between bodies reflect evidence and which reflect formulary or service constraints?

  • How should national guidelines handle cystatin C when the recommendation assumes an availability their systems do not have (Delgado 2022, PMID 34563581)?

  • Does a cardiology-led, ASN-co-authored CKM guideline (Ndumele 2026, PMID 42263157) resolve or relocate the subspecialty divergence problem that the 2023 CKM advisory named (Ndumele 2023, PMID 37807924)?

  • How should a reader reconcile GRADE 1/2 × A–D with ACC/AHA Class × Level when the two systems now cover the same clinical territory, and which content each places in its ungraded category?
  • Should guideline cycle length itself be treated as an evidence limitation? Every document in this registry closed its evidence search before the 2025–2026 finerenone and combination-therapy trials (PMIDs: 40470996, 41780000, 42246672, 42248158).
  • Which risk number should be presented to a patient first — kidney failure risk from KFRE (PMID 26757465) or total cardiovascular risk from PREVENT (PMID 37947085) — given that for most people with CKD the second is far larger and no guideline specifies an order?

References

  1. KDIGO CKD Work Group et al. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int. 2024;105(4S):S117-S314. PMID 38490803
  2. Levin et al. Executive summary of the KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease: known knowns and known unknowns. Kidney Int. 2024;105(4):684-701. PMID 38519239
  3. Cheung et al. Executive summary of KDIGO 2021 Blood Pressure in CKD guideline. Kidney Int. 2021;99(3):559-569. PMID 33637203
  4. Rossing et al. Executive summary of KDIGO 2022 Diabetes Management in CKD guideline. Kidney Int. 2022;102(5):990-999. PMID 36272755
  5. Babitt et al. Executive Summary of the KDIGO 2026 Clinical Practice Guideline for the Management of Anemia in Chronic Kidney Disease. Kidney Int. 2026;109(1):44-56. PMID 41485807
  6. Ketteler et al. Executive summary of the 2017 KDIGO Chronic Kidney Disease-Mineral and Bone Disorder Guideline Update. Kidney Int. 2017;92(1):26-36. PMID 28646995
  7. Ikizler et al. KDOQI Clinical Practice Guideline for Nutrition in CKD: 2020 Update. Am J Kidney Dis. 2020;76(3 Suppl 1):S1-S107. PMID 32829751
  8. Tonelli et al. Lipid management in chronic kidney disease: synopsis of the KDIGO 2013 clinical practice guideline. Ann Intern Med. 2014;160(3):182. PMID 24323134
  9. Perkovic et al. Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes. N Engl J Med. 2024;391(2):109-121. PMID 38785209
  10. GBD CKD Collaboration et al. Global, regional, and national burden of chronic kidney disease, 1990-2017. Lancet. 2020;395(10225):709-733. PMID 32061315
  11. Cirillo et al. A population-based approach for the definition of chronic kidney disease: CKD Prognosis Consortium. J Nephrol. 2012;25(1):7-12. PMID 22038337
  12. Matsushita et al. Cohort profile: the chronic kidney disease prognosis consortium. Int J Epidemiol. 2013;42(6):1660-1668. PMID 23243116
  13. CKD Prognosis Consortium et al. Estimated GFR, Albuminuria, and Adverse Outcomes: individual-participant data meta-analysis. JAMA. 2023;330(13):1266-1277. PMID 37787795
  14. Inker et al. Relationship of Estimated GFR and Albuminuria to Concurrent Laboratory Abnormalities. Am J Kidney Dis. 2019;73(2):206-217. PMID 30348535
  15. Inker et al. New Creatinine- and Cystatin C-Based Equations to Estimate GFR without Race. N Engl J Med. 2021;385(19):1737-1749. PMID 34554658
  16. Delgado et al. A Unifying Approach for GFR Estimation: Recommendations of the NKF-ASN Task Force on Reassessing the Inclusion of Race in Diagnosing Kidney Disease. Am J Kidney Dis. 2022;79(2):268-288.e1. PMID 34563581
  17. Tangri et al. Multinational assessment of equations predicting kidney failure. JAMA. 2016;315(2):164-174. PMID 26757465
  18. Grams et al. Kidney Failure Risk Equation evaluation with novel inputs in 59 cohorts. J Am Soc Nephrol. 2023;34(3):482-494. PMID 36857500
  19. Matsushita et al. eGFR and albuminuria for prediction of cardiovascular outcomes: individual-participant meta-analysis. Lancet Diabetes Endocrinol. 2015;3(7):514-525. PMID 26028594
  20. Heerspink et al. Dapagliflozin in Patients with Chronic Kidney Disease. N Engl J Med. 2020;383(15):1436-1446. PMID 32970396
  21. EMPA-KIDNEY Collaborative Group et al. Empagliflozin in Patients with Chronic Kidney Disease. N Engl J Med. 2023;388(2):117-127. PMID 36331190
  22. Perkovic et al. Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy. N Engl J Med. 2019;380(24):2295-2306. PMID 30990260
  23. Gong et al. Chronic Kidney Disease Prevalence and Awareness Among US Adults. JAMA Cardiol. 2026;11(1):77-81. PMID 41205219
  24. van Mil et al. Cost-effectiveness of screening for chronic kidney disease: evidence and gaps. Clin Kidney J. 2024;17(1):sfad254. PMID 38213490
  25. van Mil et al. Screening for chronic kidney disease: change of perspective and novel developments. Curr Opin Nephrol Hypertens. 2024;33(6):583-592. PMID 39137037
  26. Yeo et al. Cost-effectiveness of screening for CKD in the general adult population: systematic review. Clin Kidney J. 2024;17(1):sfad137. PMID 38186904
  27. Cusick et al. Balancing Efficiency and Equity in Population-Wide CKD Screening. JAMA Netw Open. 2025;8(4):e254740. PMID 40227684
  28. Rao et al. Chronic kidney disease of unknown aetiology: a global review. Trop Med Int Health. 2023;28(8):588-600. PMID 37403003
  29. Sanchez Polo et al. Mesoamerican Nephropathy: What We Know so Far. Int J Nephrol Renovasc Dis. 2020;13:261-272. PMID 33116757
  30. Wynn et al. Cellular and molecular mechanisms of fibrosis. J Pathol. 2008;214(2):199-210. PMID 18161745
  31. Hostetter et al. Hyperfiltration in remnant nephrons: a potentially adverse response to renal ablation. Am J Physiol. 1981;241(1):F85-F93. PMID 7246778
  32. Wen et al. Relative risks of CKD for mortality and end-stage renal disease across races are similar. Kidney Int. 2014;86(4):819-827. PMID 24522492
  33. Agarwal R, et al. Finerenone with Empagliflozin in Chronic Kidney Disease and Type 2 Diabetes. N Engl J Med. 2025;393(6):533-543. PMID 40470996
  34. Heerspink HJL, et al. Finerenone in Type 1 Diabetes and Chronic Kidney Disease. N Engl J Med. 2026;394(10):947-957. PMID 41780000
  35. Heerspink HJL, et al. Finerenone in Persons with Chronic Kidney Disease without Diabetes. N Engl J Med. 2026;395(6):533-545. PMID 42246672
  36. Neuen BL, et al. Efficacy and safety of finerenone in patients with chronic kidney disease: an individual participant data pooled analysis (INFINITY). Lancet. 2026;407(10546):2375-2386. PMID 42248158
  37. Ndumele CE, et al. 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome. Circulation. 2026;154(4):e50-e158. PMID 42263157
  38. Ndumele CE, et al. 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2026;87(22S):e1889-e2007. PMID 42265997
  39. Ndumele CE, et al. Cardiovascular-Kidney-Metabolic Health: A Presidential Advisory From the American Heart Association. Circulation. 2023;148(20):1606-1635. PMID 37807924
  40. American Diabetes Association Professional Practice Committee. 11. Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes-2026. Diabetes Care. 2026;49(Suppl 1):S246-S260. PMID 41358881
  41. Martinez YV, et al. Chronic kidney disease: summary of updated NICE guidance. BMJ. 2021;374:n1992. PMID 34489303
  42. Cusick MM, et al. Population-Wide Screening for Chronic Kidney Disease: A Cost-Effectiveness Analysis. Ann Intern Med. 2023;176(6):788-797. PMID 37216661
  43. Cusick MM, et al. When to Start Population-Wide Screening for Chronic Kidney Disease: A Cost-Effectiveness Analysis. JAMA Health Forum. 2024;5(11):e243892. PMID 39514193
  44. Fu EL, et al. Accuracy of GFR Estimating Equations in Patients with Discordances between Creatinine and Cystatin C-Based Estimations. J Am Soc Nephrol. 2023;34(7):1241-1251. PMID 36995139
  45. Khan SS, et al. Development and Validation of the American Heart Association's PREVENT Equations. Circulation. 2024;149(6):430-449. PMID 37947085
  46. Neuen BL, et al. Multinational validation of the PREVENT and SCORE2 cardiovascular risk equations across 6.4 million individuals. Nat Med. 2026;32(7):2629-2638. PMID 42086979
  47. Wanner C, et al. KDIGO Clinical Practice Guideline for Lipid Management in CKD: summary of recommendation statements and clinical approach to the patient. Kidney Int. 2014;85(6):1303-1309. PMID 24552851