KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease

Paul E. Stevens; Sofia B. Ahmed; Juan Jesús Carrero; Bethany J. Foster; Anna Francis

doi:10.1016/j.kint.2023.10.018

KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease

Paul E. Stevens, Sofia B. Ahmed, Juan Jesús Carrero, Bethany J. Foster, Anna Francis, Rasheeda K. Hall, William G. Herrington, G. Hill, Lesley A. Inker, Rümeyza Kazancıoğlu, Edmund J. Lamb, Peter Lin, Magdalena Madero, Natasha J. McIntyre, Kelly Morrow...

Elsevier BV (2024) • Volume 105, Issue 4, Pages S117-S314

GuidelineGuidelinePDF AvailableGrade EligiblePre-registered (protocol)

Overall Assessment

Exceptional Methodological Quality

Assessment created by PaperScores Medical AI v0.1.0 on Dec 14, 2025

A-

86/100

Key Takeaways

•Adopt eGFRcr-cys when eGFRcr is less accurate; measure mGFR if critical (Rec 1.2.2.1, S151).
•Use ACR with GFR for staging and risk; monitor per risk grid (Fig 13, S197).
•Treat adults with CKD and ACR≥200 mg/g or heart failure with SGLT2i (Rec 3.7.2, S214).
•Start/maintain RASi in albuminuric CKD; manage hyperkalaemia rather than stop (PP 3.6.3–3.6.7, S158–S215).
•Use risk equations (e.g., KFRE) to guide referral and KRT planning (Rec 2.2.1, S199).

Conclusion

A rigorous, globally relevant KDIGO update with transparent GRADE methods delivering actionable CKD care guidance.

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Quality Dimensions

Bias & Integrity

COI handling, outcome switching, selective reporting

B+84

Methods Rigour

Protocol clarity, sampling, controls

A-88

External Validity

Generalisability, setting, population

A90

Transparency & Reproducibility

Data/code/materials availability, preregistration

B+80

Significance & Novelty

Contribution vs prior art; context if known

A90

Statistical Validity

Models, assumptions, multiplicity, CI priority

A-85

Integrity & Transparency

Integrity checks

P-hacking risk?

?

None suspected

Signs of selective hypothesis testing or analysis choices that could inflate false positive rates.

Outcome switching?

?

None suspected

Evidence that primary outcomes were changed during or after the study, potentially distorting results.

Conflict of interest?

?

None suspected

Authors have financial or other relationships that could bias research findings.

Data integrity issues?

?

None suspected

Concerns about the accuracy, completeness, or authenticity of the reported data.

Open science signals

Research data

?

Not applicable

Raw data used in the analyses is publicly available or accessible upon request.

Analysis code

?

Not applicable

Code or scripts used to analyze the data are shared for reproducibility.

Study materials

?

Not applicable

Protocols, questionnaires, and other materials are publicly available.

Premise

Primary Research Question

Provide evidence-based recommendations for evaluation and management of CKD across the lifespan.

Hypothesis is Falsifiable

—Not specified

Guideline synthesis, not a hypothesis-testing study.

PICO Framework

Population✓Yes

Adults and children with CKD; dialysis and transplant recipients generally excluded from scope.

Intervention✓Yes

Evaluation (GFR/albuminuria), risk tools, lifestyle, SGLT2i, RASi, MRA, GLP-1 RA, care models.

Comparison✓Yes

Recommendations based on SRs comparing interventions vs placebo/usual care.

Outcome✓Yes

Kidney failure, eGFR decline, CV events, mortality, hospitalisation, harms.

Literature Positioning

Literature Review Balanced

Well covered

De novo SRs, external validations and meta-analyses across topics.

Evidence: Methods S274–S281; Fig 57 PRISMA S279.

Research Gap Clearly Stated

Well covered

Dedicated chapter on research recommendations.

Evidence: S270–S273.

Stated Contribution Clear

Well covered

Update of KDIGO 2012 with graded recommendations and practice points.

Evidence: Abstract S133; Introduction S135–S137.

Study Provenance

Peer reviewed venueFunding disclosedConflict disclosure providedAffiliations listed

Authors & Affiliations

KDIGO Work Group; global multidisciplinary team from universities and hospitals (S131–S133).

Funding Statement

Supplement sponsored by KDIGO; views authors’ own; open access CC BY-NC-ND (S129 Notice).

Conflicts of Interest

Full disclosures for all Work Group members provided (S283–S293).

Peer Review

✓Published in Kidney International Supplement 2024; journal peer reviewed.

Evidence: Front matter and citation S118–S121.

Methodological Assessment

All design modules are marked as not applicable. Use the accordion below to review their details.

Modules without applicable checklist items (10)

These designs were fully marked as not applicable but remain available for reference.

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Study Overview

Study Design

Guideline

Primary classification used to evaluate this research.

Population

Adults and children with or at risk of chronic kidney disease; guidance for evaluation, risk assessment, management, and models of care.

Brief summary of who or what was studied.

Pre-registration

Protocol published

Indicates whether the protocol or trial was registered before data collection.

Reviewer Notes

Guideline synthesising evidence via systematic reviews and GRADE; not a primary empirical study.

Publication Details

DOI

10.1016/j.kint.2023.10.018

Published

March 13, 2024

Citations

6044 citations

FWCI

2057.60

External Resources

DOI Link OpenAlex

Disclaimer: This assessment is generated by AI and should not be the sole basis for clinical or research decisions. Always review the original paper and consult with domain experts.

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