# KDIGO 2022 guideline for diabetes management in CKD Guideline · id `cardio:guideline-kdigo-2022-diabetes-ckd` · Cardiovascular Atlas · release `5dcd9b263fe17744` (public) > General information from published sources, not medical advice, and not reviewed by clinicians. Check the cited source before relying on anything here. The atlas's own text and curation may be reused under Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0, https://creativecommons.org/licenses/by-nc/4.0/): credit the atlas, and do not use it commercially. See the atlas About page. Text quoted from a source stays under that source's own terms, given as the source's reuse\_basis. The atlas's reuse terms do not cover it. The downloads list each quotation with its source in third\_party\_quotations. Also called: KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease Browse, organ or system: Kidneys; Metabolism Browse, condition area: Diabetes and metabolic disease; Kidney connections ## In plain language The 2022 clinical practice guideline from Kidney Disease: Improving Global Outcomes on managing diabetes in people with chronic kidney disease. Only the PubMed bibliographic record could be read. It has no abstract, and the full text is behind a subscription, so this page gives no recommendations. ## Technical summary Kidney International 2022;102(5S):S1-S127, doi 10.1016/j.kint.2022.06.008, PMID 36272764. PubMed names the KDIGO Diabetes Work Group as author. Europe PMC lists the full text as subscription required, and the KDIGO page returned HTTP 406 to a plain script request, which was not worked around. The guideline's own recommendations are therefore not recorded here. A separate joint consensus report that draws on this guideline is recorded in this atlas and carries the care steps and the finerenone limits. A 2024 commentary on the 2022 update gives a short, secondary description of what changed; it is recorded as a separate claim. ## Claims, with the population each applies to ## Context: People with diabetes and chronic kidney disease (KDOQI commentary on the KDIGO 2022 update) Recipient: Recipient not specified; Population: People with diabetes and chronic kidney disease, the subject of the KDIGO guideline that the commentary discusses. The abstract gives no age limits and no inclusion criteria.; Care setting: Not stated in the abstract. The commentary discusses what the changes mean for care in the United States.; Geography: Global guideline; the commentary addresses the United States; Life stage: Not stated in the abstract; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Not applicable (guideline context) ### A 2024 commentary from the Kidney Disease Outcomes Quality Initiative, convened by the National Kidney Foundation, says the KDIGO guideline on diabetes management in chronic kidney disease was updated in 2022, two years after the previous update. It says the changes include a lower kidney-function threshold for starting an SGLT2 inhibitor (an estimated glomerular filtration rate of 20 mL/min/1.73 m2 or more) and the addition of finerenone, a nonsteroidal mineralocorticoid receptor antagonist, as an agent aimed at cutting cardiorenal end points. - Category: Description - Evidence stage: Guidance - Certainty: Certainty not assessed - Applies to: Recipient: Recipient not specified; Population: People with diabetes and chronic kidney disease, the subject of the KDIGO guideline that the commentary discusses. The abstract gives no age limits and no inclusion criteria.; Care setting: Not stated in the abstract. The commentary discusses what the changes mean for care in the United States.; Geography: Global guideline; the commentary addresses the United States; Life stage: Not stated in the abstract; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Not applicable (guideline context) - Limitations: The source is the abstract of a commentary on the guideline, not the guideline. The abstract gives an eGFR threshold for starting an SGLT2 inhibitor but no albuminuria or potassium limit for finerenone and no class or grade, so no finerenone recommendation is written. The commentary is written for the United States; the KDIGO guideline is global. PubMed lists no correction to the commentary (checked 2026-10-15). - Last checked: 2026-10-15 - Sources: 1. Supports: KDOQI Commentary on the KDIGO 2022 Update to the Clinical Practice Guideline for Diabetes Management in CKD (Publication, edition Commentary in American Journal of Kidney Diseases 83(3), issue dated March 2024 in PubMed. PubMed abstract and bibliographic data only (fetched 2026-10-15); PubMed lists no PMC copy. The commentary text was not read. The publisher field is the journal as PubMed names it.) Locator: Abstract, sentence 1, fragments 1 and 2. Retrieved 2026-10-15T14:23:20Z. Source state: Current. Snapshot hash: 3b896ddc2bc6dbe6b026616f41ff0cfbd50e466bfefbabde3a5e577fc56f2537. How it applies: The guideline was updated in 2022, two years after the previous update. 2. Background: KDOQI Commentary on the KDIGO 2022 Update to the Clinical Practice Guideline for Diabetes Management in CKD (Publication, edition Commentary in American Journal of Kidney Diseases 83(3), issue dated March 2024 in PubMed. PubMed abstract and bibliographic data only (fetched 2026-10-15); PubMed lists no PMC copy. The commentary text was not read. The publisher field is the journal as PubMed names it.) Locator: Abstract, sentence 3, fragments 1 and 2. Retrieved 2026-10-15T14:23:20Z. Source state: Current. Snapshot hash: 3b896ddc2bc6dbe6b026616f41ff0cfbd50e466bfefbabde3a5e577fc56f2537. How it applies: Who wrote the commentary and what it covers. 3. Supports: KDOQI Commentary on the KDIGO 2022 Update to the Clinical Practice Guideline for Diabetes Management in CKD (Publication, edition Commentary in American Journal of Kidney Diseases 83(3), issue dated March 2024 in PubMed. PubMed abstract and bibliographic data only (fetched 2026-10-15); PubMed lists no PMC copy. The commentary text was not read. The publisher field is the journal as PubMed names it.) Locator: Abstract, sentence 4, fragments 1 to 3. Retrieved 2026-10-15T14:23:20Z. Source state: Current. Snapshot hash: 3b896ddc2bc6dbe6b026616f41ff0cfbd50e466bfefbabde3a5e577fc56f2537. How it applies: SGLT2 inhibitors recast as cardiorenal-metabolic therapeutics; lower kidney-function threshold to start one. 4. Supports: KDOQI Commentary on the KDIGO 2022 Update to the Clinical Practice Guideline for Diabetes Management in CKD (Publication, edition Commentary in American Journal of Kidney Diseases 83(3), issue dated March 2024 in PubMed. PubMed abstract and bibliographic data only (fetched 2026-10-15); PubMed lists no PMC copy. The commentary text was not read. The publisher field is the journal as PubMed names it.) Locator: Abstract, sentence 5, fragments 1 and 2. Retrieved 2026-10-15T14:23:20Z. Source state: Current. Snapshot hash: 3b896ddc2bc6dbe6b026616f41ff0cfbd50e466bfefbabde3a5e577fc56f2537. How it applies: Finerenone added to reduce cardiorenal end points. ## Connected pages - Issuer: the work group is named as author in the PubMed record: Kidney Disease: Improving Global Outcomes (KDIGO) (`cardio:kdigo`) ## Provenance Content hash: 0fbff2b4eb566a3f9701410a73d45a0b05d822e474023b4b7d99e5f309d7587b Last substantive edit: 2026-10-15 Evidence last checked: 2026-10-15