Preventing chronic kidney disease and maintaining kidney health: conclusions from a KDIGO Controversies Conference
A KDIGO Controversies Conference concluded that preventing chronic kidney disease and maintaining kidney health — long neglected in favour of managing progression — should become a global priority, framed within the cardiovascular-kidney-metabolic syndrome and pursued through lifestyle change, risk-factor control, and emerging pharmacotherapy.
Background
To date, CKD care has focused on managing disease progression, complications, and kidney failure, while maintaining kidney health and preventing CKD have received limited attention despite their potential to save lives and reduce costs. This KDIGO Controversies Conference addressed that gap using the cardiovascular-kidney-metabolic (CKM) concept, which frames CKD as part of a complex, high-risk syndrome requiring global risk assessment and multifactorial intervention.
Key findings
The conference concluded that CKD incidence and CKM risk factors may be reduced by a healthy diet, physical activity, and a supportive environment, but that residual risk persists despite healthy lifestyles and risk-factor treatment. Post hoc analyses of clinical trials suggest pharmacological interventions such as SGLT2 inhibitors and GLP-1 receptor agonists may help prevent or regress CKD in individuals with type 2 diabetes or obesity, though dedicated trials are needed to validate these findings in broader high-risk populations.
Clinical implications
Personalised prevention should combine targeted CKD risk prediction (targeted testing, genetic or biomarker assessment), shared decision-making, cost considerations, and careful therapy selection while weighing potential adverse effects — adopting a lifespan approach to risk evaluation aimed at maintaining kidney health rather than waiting to treat established CKD.
Category
KDIGO
Source
Kidney International
More from ASNRT News
Browse the latest news, society announcements, KDIGO guideline updates, and AJNT issue releases on the ASNRT newsroom.