KDIGO 2026 CKD Guidelines: Key Updates for Nephrology Practice

Overview of the 2026 KDIGO CKD Guideline Updates

The Kidney Disease: Improving Global Outcomes (KDIGO) organization released updated clinical practice guidelines for chronic kidney disease management in early 2026. These guidelines represent the most significant revision to CKD management recommendations in several years, incorporating new evidence from landmark trials including FLOW, EMPA-KIDNEY, and DAPA-CKD.

SGLT2 Inhibitor Recommendations Expanded

The updated guidelines now recommend SGLT2 inhibitors for all patients with CKD and eGFR 20-45, regardless of diabetes status. This represents a significant expansion from the 2024 guidelines which limited the recommendation to eGFR above 25.

GLP-1 Receptor Agonists Enter CKD Guidelines

For the first time, GLP-1 receptor agonists are included in CKD management guidelines based on the FLOW trial data showing semaglutide reduced the primary kidney composite endpoint by 24%.