KDIGO’s 2024 Updated Guidelines Re-Emphasize the Importance of Comprehensive Testing for Chronic Kidney Disease

More than 37 million adults in the U.S. have chronic kidney disease (CKD). Unfortunately, about 90% of them are unaware of their condition, as people may not experience symptoms until their disease has advanced. Even among those with severely reduced kidney function (but not on dialysis), 40% are not aware they have CKD. This disease is a leading cause of death in the US, and its burden has been steadily growing over the last decade, with significant toll on patients, society and healthcare costs. It’s critical to implement successful strategies for early testing, prompt diagnosis and effective treatment in people at risk of developing CKD. This is especially necessary for those with type 2 diabetes and high blood pressure, the two leading causes of kidney disease. Other important risk factors for CKD include obesity, heart failure and other heart disease, aging, smoking or use of tobacco products, and family history, among others. Early detection is more effective when combined with the appropriate risk stratification and the timely implementation of guideline-directed medical therapy. 

Given the nature of CKD and the negative impact it can have on patients, I am encouraged to see the updated 2024 clinical practice guidelines from KDIGO (Kidney Disease: Improving Global Outcomes), published in March. Significant new data emerged in the last 12 years, which informed KDIGO’s recommendations for CKD screening, treatment and management. The updated 2024 guidelines:

• Expand upon screening recommendations for CKD using both estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR) tests to stage and stratify CKD 
• Support a holistic approach to CKD treatment and risk modification
• Include lifestyle recommendations for the management of CKD, with guidance for healthy diet, physical activity, stopping the use of tobacco products, and weight management 
• Recommend SGLT2i as a first-line drug therapy option for those with CKD, in addition to blood pressure control, statin-based therapy and targeted therapies for complications 
• Provide a table of risk factors including hypertension and diabetes, among others

CKD is a chronic condition that, when caught early, the risk of progression can be reduced. The 2024 KDIGO guidelines strongly support efforts aimed at early detection and treatment of CKD among people at high risk for the condition, including those with high blood pressure, diabetes and cardiovascular disease. While there is still room for even further improvement to address unmet needs in testing, diagnosis and management, it is critical for healthcare professionals to adopt these updated clinical guidelines in their practice, and help implement the appropriate early CKD screening, especially for those at increased risk, using both eGFR and UACR. 

The Boehringer Ingelheim and Lilly Alliance is committed to supporting the appropriate education for healthcare professionals and patients to prioritize kidney health. By screening for and detecting CKD early, healthcare professionals can help patients better manage the condition, potentially delaying disease progression and reducing long-term complications.