Updated NICE guideline covers investigation and treatment of chronic kidney disease and associated disorders

Kidneys and adrenal glands 3d visualisation

NICE has updated NICE Guideline (NG) 203 on the assessment and management of chronic kidney disease (CKD), with the aim of preventing or delaying its progression and reducing the risk of complications and cardiovascular disease.

The guideline covers care and treatment for people who have CKD or are at risk of developing it. It also includes advice on the management of anaemia and hyperphosphataemia associated with CKD. Comorbidites such as cardiovascular disease and diabetes often occur with CKD, and moderate to severe CKD is associated with increased risk of acute kidney injury, falls, frailty and mortality.

The guideline provides new and updated recommendations on:

  • investigation and classification of CKD
  • risk assessment and referral criteria
  • blood pressure control
  • pharmacotherapy
  • phosphate binders to manage mineral and bone disorders
  • glomerular filtration rate for diagnosing associated anaemia
  • intravenous iron for treatment of anaemia.

NICE is currently reviewing the evidence on sodium glucose co-transporter 2 inhibitors for people with CKD and type 2 diabetes; a further update is expected in November 2021.

NG203 updates and replaces Clinical Guideline (CG) 182, published in July 2014; NG8, published in June 2015; and CG157, issued in March 2013.