Clinical Practice Guideline for detection and management of diabetic kidney disease: A consensus report by the Spanish Society of Nephrology

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Clinical Practice Guideline for detection and management of diabetic kidney disease: A consensus report by the Spanish Society of Nephrology

Publicated to:NEFROLOGIA 45 (): 1-26 - 2025-04-01 45(), DOI: 10.1016/j.nefro.2024.11.002

Authors: Montero, Nuria; Oliveras, Laia; Martinez-Castelao, Alberto; Gorriz, Jose Luis; Soler, Maria Jose; Fernandez-Fernandez, Beatriz; Quero, Maria; Garcia-Carro, Clara; Garcia-Sancho, Paula; Goicechea, Marian; Martinez, Juan Jose Gorgojo; Molina, Pablo; Puchades, Maria Jesus; Rodriguez-Espinosa, Diana; Sablon, Nery; Santamaria, Rafael; Navarro-Gonzalez, Juan Francisco

Affiliations

Complex Hosp Univ Moises Broggi, Serv Endocrinol & Nutr, Barcelona, Spain - Author

Hosp Clin Barcelona, Serv Nefrol, Barcelona, Spain - Author

Hosp Gen Univ Gregorio Maranon, Serv Nefrol, RICORS 2040 Kidney Dis, Madrid, Spain - Author

Hosp Univ Bellvitge, Serv Nefrol, Barcelona, Spain - Author

Hosp Univ Fdn Alcorcon, Serv Endocrinol & Nutr, Madrid, Spain - Author

Hosp Univ Gran Canaria Dr Negrin, Serv Nefrol, Las Palmas Gran Canaria, Spain - Author

Hosp Univ Nuestra Senora Candelaria, Serv Nefrol, Santa Cruz De Tenerife, Spain - Author

Hosp Univ Nuestra Senora Candelaria, Unidad Invest, Santa Cruz De Tenerife, Spain - Author

Hosp Univ Vall dHebron, Vall dHebron Inst Res, Serv Nefrol, Barcelona, Spain - Author

Inst Salud Carlos III, RICORS2040 Kidney Dis RD21 0005 0013, Madrid, Spain - Author

RICORS2040 Kidney Dis RD21 0005 0013, Valencia, Spain - Author

Univ Autonoma Madrid, IIS Fdn Jimenez Diaz, Dept Med, Serv Nefrol & Hipertens,Fac Med,RICORS2040, Madrid, Spain - Author

Univ Complutense Madrid, Hosp Univ Clin San Carlos, Serv Nefrol, Madrid, Spain - Author

Univ Cordoba, Hosp Univ Reina Sofia, Serv Nefrol, Inst Maimonides Invest Biomed Cordoba IMIB, Cordoba, Spain - Author

Univ Fernando Pessoa Canarias, Fac Ciencias Salud, Las Palmas Gran Canaria, Spain - Author

Univ La Laguna, Inst Tecnol Biomed, San Cristobal la Laguna, Spain - Author

Univ Valencia, Hosp Clin Univ Valencia, Serv Nefrol, Valencia, Spain - Author

Univ Valencia, Hosp Univ Dr Peset, Serv Nefrol, FISABIO, Valencia, Spain - Author

Abstract

To address all the changes in the management of people with diabetes (DM) and chronic kidney disease (CKD), under the auspices of the Spanish Society of Nephrology (SEN), the Spanish Diabetic Nephropathy Study Group (GEENDIAB) decided to publish an updated Clinical Practice Guideline for detection and management of diabetic kidney disease (DKD). It is aimed at a wide audience of clinicians treating diabetes and CKD. The terminology of kidney disease in diabetic patients has evolved towards a more inclusive nomenclature that avoids underdiagnosis of this entity. Thus, the terms "diabetes and kidney disease" and "diabetic kidney disease" are those proposed in the latest KDIGO 2022 guidelines to designate the whole spectrum of patients who can benefit from a comprehensive therapeutic approach only differentiated according to eGFR range and albuminuria. Recommendations have been divided into five main areas of interest: Chapter 1: Screening and diagnosis of diabetic kidney disease, Chapter 2: Metabolic control in people with diabetes and CKD, Chapter 3: Blood pressure control in people with diabetic kidney disease, Chapter 4: Treatment targeting progression of CKD in people with diabetic kidney disease, and Chapter 5: Antiplatelet or anticoagulant therapy in people with diabetes and CKD. World Health Organization (WHO) recommendations for guideline development were followed to report this guideline. Systematic reviews were carried out, with outcome ratings and summaries of findings, and we reported the strength of recommendations following the "Grading of Recommendations Assessment, Development and Evaluation" GRADE evidence profiles. (c) 2024 Sociedad Espanola de Nefrolog & imath;a. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/ by-nc-nd/4.0/).

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