KDIGO guidelines on treatment of diabetes mellitus in chronic kidney disease : German translation and executive summary

Abstract

The Kidney disease: improving global outcomes (KDIGO) guidelines on the management of diabetes in chronic kidney disease, which were published in June 2020, are the first KDIGO guidelines on this topic. The guidelines were published against the background that advances in the treatment of diabetes and technological innovations open up new options for treatment of the many patients with diabetes mellitus and chronic kidney disease who have a high risk for a poor prognosis. The continuously increasing evidence base from randomized clinical studies enables patients to be offered new treatment options with respect to organ protection. These include sodium glucose-linked transporter 2 (SGLT2) inhibitors and glucagon-like peptide 1 (GLP-1) receptor agonists. The aim of the new guidelines is to provide evidence-based recommendations for optimization of the care of people with diabetes and chronic kidney disease, whereby the new treatment options were coupled with already existing treatment strategies. In addition to the evidence-based recommendations, the guidelines contain so-called points of practice, i.e. practical tips for the implementation of the guidelines. The points of practice are only expert opinions and as a rule are not supported by randomized studies. The guidelines are concerned with the interdisciplinary care of patients with diabetes and chronic kidney disease, including glycemic control with blood glucose as well as continuous interstitial glucose measurements (CGM), with appropriate treatment targets and selection of antidiabetic drugs. Additionally, lifestyle alterations, self-management and possible adaptations of the healthcare system are discussed in order to comprehensively care for people with diabetes and chronic kidney disease.