Practice Guideline

. 2025 Feb;42(2):e15450.

doi: 10.1111/dme.15450. Epub 2024 Oct 17.

Current management of chronic kidney disease in type-2 diabetes-A tiered approach: An overview of the joint Association of British Clinical Diabetologists and UK Kidney Association (ABCD-UKKA) guidelines

Indranil Dasgupta¹, Sagen Zac-Varghese², Khuram Chaudhry³, Kieran McCafferty⁴, Peter Winocour², Tahseen A Chowdhury⁵, Srikanth Bellary⁶, Gabrielle Goldet⁷, Mona Wahba⁸, Parijat De⁹, Andrew H Frankel⁷, Rosa M Montero¹⁰, Eirini Lioudaki¹¹, Debasish Banerjee¹², Ritwika Mallik¹³, Adnan Sharif¹⁴, Naresh Kanumilli¹⁵, Nicola Milne¹⁶, Dipesh C Patel¹⁷, Ketan Dhatariya¹⁸, Stephen C Bain¹⁹, Janaka Karalliedde²⁰

Affiliations

¹ Heartlands Hospital, Birmingham and Warwick Medical School, University of Warwick, Coventry, UK.
² East and North Herts NHS Trust, Hertfordshire, UK.
³ Guy's and St Thomas' Hospital, London, UK.
⁴ Barts Health NHS Trust, London, UK.
⁵ Royal London Hospital, London, UK.
⁶ Aston University, Birmingham, UK.
⁷ Imperial College Healthcare NHS Trust, London, UK.
⁸ Epsom & St Helier University NHS Trust, London, UK.
⁹ City Hospital, Birmingham, UK.
¹⁰ St George's Hospital, London, UK.
¹¹ King's College Hospital, London, UK.
¹² St George's University Hospitals NHS Foundation Trust, London, UK.
¹³ University College London NHS Trust, London, UK.
¹⁴ University Hospitals Birmingham, Birmingham, UK.
¹⁵ Northenden Group Practice, Manchester, UK.
¹⁶ Greater Manchester Diabetes Clinical Network, Manchester, UK.
¹⁷ Royal Free London NHS Foundation Trust, London, UK.
¹⁸ Norfolk and Norwich University Hospitals NHS Foundation Trust and Norwich Medical School, University of East Anglia, Norwich, UK.
¹⁹ Swansea University, Swansea, UK.
²⁰ Guy's and St Thomas' Hospital London and King's College London, London, UK.

PMID: 39415639
PMCID: PMC11733655
DOI: 10.1111/dme.15450

Practice Guideline

Current management of chronic kidney disease in type-2 diabetes-A tiered approach: An overview of the joint Association of British Clinical Diabetologists and UK Kidney Association (ABCD-UKKA) guidelines

Indranil Dasgupta et al. Diabet Med. 2025 Feb.

. 2025 Feb;42(2):e15450.

doi: 10.1111/dme.15450. Epub 2024 Oct 17.

Authors

Affiliations

¹ Heartlands Hospital, Birmingham and Warwick Medical School, University of Warwick, Coventry, UK.
² East and North Herts NHS Trust, Hertfordshire, UK.
³ Guy's and St Thomas' Hospital, London, UK.
⁴ Barts Health NHS Trust, London, UK.
⁵ Royal London Hospital, London, UK.
⁶ Aston University, Birmingham, UK.
⁷ Imperial College Healthcare NHS Trust, London, UK.
⁸ Epsom & St Helier University NHS Trust, London, UK.
⁹ City Hospital, Birmingham, UK.
¹⁰ St George's Hospital, London, UK.
¹¹ King's College Hospital, London, UK.
¹² St George's University Hospitals NHS Foundation Trust, London, UK.
¹³ University College London NHS Trust, London, UK.
¹⁴ University Hospitals Birmingham, Birmingham, UK.
¹⁵ Northenden Group Practice, Manchester, UK.
¹⁶ Greater Manchester Diabetes Clinical Network, Manchester, UK.
¹⁷ Royal Free London NHS Foundation Trust, London, UK.
¹⁸ Norfolk and Norwich University Hospitals NHS Foundation Trust and Norwich Medical School, University of East Anglia, Norwich, UK.
¹⁹ Swansea University, Swansea, UK.
²⁰ Guy's and St Thomas' Hospital London and King's College London, London, UK.

PMID: 39415639
PMCID: PMC11733655
DOI: 10.1111/dme.15450

Abstract

A growing and significant number of people with diabetes develop chronic kidney disease (CKD). Diabetes-related CKD is a leading cause of end-stage kidney disease (ESKD) and people with diabetes and CKD have high morbidity and mortality, predominantly related to cardiovascular disease (CVD). Despite advances in care over the recent decades, most people with CKD and type 2 diabetes are likely to die of CVD before developing ESKD. Hyperglycaemia and hypertension are modifiable risk factors to prevent onset and progression of CKD and related CVD. People with type 2 diabetes often have dyslipidaemia and CKD per se is an independent risk factor for CVD, therefore people with CKD and type 2 diabetes require intensive lipid lowering to reduce burden of CVD. Recent clinical trials of people with type 2 diabetes and CKD have demonstrated a reduction in composite kidney end point events (significant decline in kidney function, need for kidney replacement therapy and kidney death) with sodium-glucose co-transporter-2 (SGLT-2) inhibitors, non-steroidal mineralocorticoid receptor antagonist finerenone and glucagon-like peptide 1 receptor agonists. The Association of British Clinical Diabetologists (ABCD) and UK Kidney Association (UKKA) Diabetic Kidney Disease Clinical Speciality Group have previously undertaken a narrative review and critical appraisal of the available evidence to inform clinical practice guidelines for the management of hyperglycaemia, hyperlipidaemia and hypertension in adults with type 2 diabetes and CKD. This 2024 abbreviated updated guidance summarises the recommendations and the implications for clinical practice for healthcare professionals who treat people with diabetes and CKD in primary, community and secondary care settings.

Keywords: ACE inhibitior; hypertension; kidney disease; lifestyle; type 2 diabetes.

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Conflict of interest statement

S.B. reports receiving personal fees from Abbott, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Merck Sharp & Dohme, Novo Nordisk, and Sanofi Aventis and being a shareholder in Glycosmedia. D.B. reports receiving speaker fees from CSLVifor, Bayer; honoraria for advisory board from Bayer; and research grant from AstraZeneca. I.D. reports receiving research grants from Baxter, Medtronic and Sanofi‐Genzyme, receiving honoraria for attending advisory board and speaker meetings from GlaxoSmithKline, AstraZeneca, Vifor, Medtronic and Sanofi‐Genzyme, and being the national lead for 3 GSK trials. P.D. reports receiving honoraria for advisory work and/or lecture fees from AstraZeneca, Boehringer Ingelheim, Eli Lilly, Merck Sharp & Dohme, Napp Pharmaceuticals, Novo Nordisk, and Sanofi. J.K. reports receiving research grants from AstraZeneca and Sanofi and receiving speaker fees and attending advisory boards from Boehringer Ingelheim, AstraZeneca, Sanofi, and Napp. K.M. reports receiving speaker fees and attending advisory board from Vifor, AstraZeneca, Bayer, Boehringer Ingelheim, Pharmacomsos, Napp, Vifor Fresenius and receiving a grant from AstraZeneca. P.W. reports receiving honoraria for delivering educational meetings and/or attending advisory boards for Abbott, AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, Merck Sharp & Dohme, Napp, Sanofi, Novo, and Vifor Pharmaceuticals. K.D. reports receiving honoraria, travel or fees for speaking or advisory boards from AstraZeneca, Novo Nordisk, Boehringer Ingelheim, Eli Lilly, Abbott Diabetes, Menarini, Sanofi Diabetes and Roche. NK reports receiving speaker fees and advisory board fees from AstraZeneca, Bohringer Ingelheim, Lilly, Sanofi, Menarini, Novartis, Daiichi Sankyo. NM reports receiving fees for educational session and events, and advisory boards from Abbot, AstraZeneca, Bayer, Boehringer Ingelheim, Lilly, Menarini, Novo Nordisk, Roche, Sanofi. All the other authors declared no competing interests.

Figures

**FIGURE 1**
Management of CKD in type‐2 diabetes: a tiered approach.

See this image and copyright information in PMC

References

1. Xie Y, Bowe B, Mokdad AH, et al. Analysis of the global burden of disease study highlights the global, regional, and national trends of chronic kidney disease epidemiology from 1990 to 2016. Kidney Int. 2018;94(3):567‐581. - PubMed
1. UK Renal Registry . UK Renal Registry 24th Annual Report—Data to 31/12/2020. Bristol; 2022. Available from https://ukkidney.org/audit‐research/annual‐report
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Current management of chronic kidney disease in type-2 diabetes-A tiered approach: An overview of the joint Association of British Clinical Diabetologists and UK Kidney Association (ABCD-UKKA) guidelines

Affiliations

Current management of chronic kidney disease in type-2 diabetes-A tiered approach: An overview of the joint Association of British Clinical Diabetologists and UK Kidney Association (ABCD-UKKA) guidelines

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

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Substances

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous