KDIGO 2024 clinical practice guideline on evaluation and management of chronic kidney disease: A primer on what pharmacists need to know.
The KDIGO 2024 chronic kidney disease guideline updates the 2012 framework with major shifts: greater use of cystatin C for GFR estimation, an individualized risk-based approach to predicting kidney failure, and broader use of SGLT2 inhibitors, finerenone, GLP-1 receptor agonists, and statins.
Background
The KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease (CKD) updates the 2012 guideline using GRADE methodology and a substantially broader evidence base. It applies to adults and children with CKD who are not receiving dialysis or a kidney transplant. The full guideline includes 28 recommendations and 141 practice points.
Key recommendations
Key updates include greater emphasis on cystatin C—often combined with creatinine—for assessing glomerular filtration rate and for drug dosing, a shift to an individualized risk-based approach (using tools such as the Kidney Failure Risk Equation) to predict kidney failure, and SGLT2 inhibitor therapy for patients with CKD and proteinuria with or without diabetes. The guideline also recommends RAAS inhibitors for blood-pressure and proteinuria control, statins for adults older than 50 with CKD, finerenone for type 2 diabetes with CKD, and GLP-1 receptor agonists for their kidney-protective effects.
Clinical implications
The guideline emphasizes nephrotoxin stewardship, prevention of AKI through sick-day medication management, and team-based, interprofessional care—highlighting roles for pharmacists in comprehensive medication management, drug-dose adjustment, and patient education. Commentaries from KDOQI (US) and ERBP (Europe) broadly concur with the recommendations while noting implementation barriers and, in Europe, advocating region-specific GFR equations such as the EKFC equation.
Category
KDIGO
Source
Am J Health Syst Pharm
More from ASNRT News
Browse the latest news, society announcements, KDIGO guideline updates, and AJNT issue releases on the ASNRT newsroom.