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Several years ago, KDIGO published a comprehensive guideline for managing diabetes in patients with chronic kidney disease (CKD; NEJM JW Gen Med Jan 15 2021 and Ann Intern Med 2021; 174:385). Because many new randomized trials have been published since, KDIGO has published an update that includes 13 graded recommendations and 52 “practice points” for clinicians. The updated guideline focuses particularly on sodium–glucose cotransporter-2 (SGLT-2) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists, and the nonsteroidal mineralocorticoid-receptor antagonist finerenone.
SGLT-2 inhibitors are recommended for patients with type 2 diab…