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Background <p>Chronic kidney disease (CKD) affects approximately 10% of the adult population in Germany. Patients with CKD face an increased risk of a progression to kidney failure or developing cardiovascular complications. The purpose of this update is to adapt the guidelines to the latest scientific evidence to ensure optimal clinical management of CKD patients at the interface between general medicine and nephrology.</p> Search strategy <p>An updated review of international clinical practice guidelines for CKD was carried out. The primary source guidelines were those of the National Institute for Health and Care Excellence (NICE) 2021 and the Kidney Disease: Improving Global Outcomes (KDIGO) 2023. Furthermore, a&#xa0;systematic literature search was conducted on the evidence situation regarding sodium-glucose linked transporter 2 (SGLT2) inhibitors in CKD. All recommendations and accompanying background texts were finalized via a&#xa0;structured consensus process.</p> Most important innovations <p>1.&#xa0;Routine assessment of albuminuria using the urine albumin-to-creatinine ratio (UACR) is recommended as a decisive factor for early detection and accurate staging of CKD (classification based on the UACR and the estimated glomerular filtration rate, eGFR).</p> <p>2.&#xa0;Risk prediction tools such as the Kidney Failure Risk Equation (KFRE) should be used to incorporate age and sex into the assessment of the risk of kidney failure.</p> <p>3.&#xa0;Ultrasound examination of the urogenital system is recommended as a diagnostic measure for all patients with suspected CKD.</p> <p>4.&#xa0;The use of SGLT2 inhibitors is recommended for patients with relevant albuminuria or moderately reduced kidney function.</p> <p>5.&#xa0;Treatment of asymptomatic hyperuricemia is not recommended.</p> <p>6.&#xa0;Vaccination recommendations issued by the Standing Committee on Vaccination (STIKO) have now been formally integrated into the guidelines.</p> Evidence gaps and research needs <p>Special importance for the treatment of CKD should be attached to changes during the lifespan considering age, sex and gender for a&#xa0;personalized approach. To date there are no age or sex/gender-sensitive recommendations on the management of CKD. This aspect should be included in the next update.</p>

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Aktualisierte Leitlinie „Chronische Nierenkrankheit in der allgemeinmedizinischen Praxis“

  • 期刊论文

  • 发表日期：

    2025年8月4日

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  • Sylvia Stracke,
  • Simone Kiel,
  • Martha Negnal,
  • Leonard Mathias,
  • Elizabeth Mathias,
  • Til Uebel,
  • Erika Baum,
  • Susanne Fleig,
  • Martin K. Kuhlmann,
  • Jan Galle,
  • Julia Weinmann-Menke,
  • Joachim Seffrin,
  • Thomas Weinreich,
  • Michael Daschner,
  • Maik Gollasch,
  • Ute Hoffmann,
  • Annette Diehl,
  • Jean-François Chenot

摘要

Background

Chronic kidney disease (CKD) affects approximately 10% of the adult population in Germany. Patients with CKD face an increased risk of a progression to kidney failure or developing cardiovascular complications. The purpose of this update is to adapt the guidelines to the latest scientific evidence to ensure optimal clinical management of CKD patients at the interface between general medicine and nephrology.

Search strategy

An updated review of international clinical practice guidelines for CKD was carried out. The primary source guidelines were those of the National Institute for Health and Care Excellence (NICE) 2021 and the Kidney Disease: Improving Global Outcomes (KDIGO) 2023. Furthermore, a systematic literature search was conducted on the evidence situation regarding sodium-glucose linked transporter 2 (SGLT2) inhibitors in CKD. All recommendations and accompanying background texts were finalized via a structured consensus process.

Most important innovations

1. Routine assessment of albuminuria using the urine albumin-to-creatinine ratio (UACR) is recommended as a decisive factor for early detection and accurate staging of CKD (classification based on the UACR and the estimated glomerular filtration rate, eGFR).

2. Risk prediction tools such as the Kidney Failure Risk Equation (KFRE) should be used to incorporate age and sex into the assessment of the risk of kidney failure.

3. Ultrasound examination of the urogenital system is recommended as a diagnostic measure for all patients with suspected CKD.

4. The use of SGLT2 inhibitors is recommended for patients with relevant albuminuria or moderately reduced kidney function.

5. Treatment of asymptomatic hyperuricemia is not recommended.

6. Vaccination recommendations issued by the Standing Committee on Vaccination (STIKO) have now been formally integrated into the guidelines.

Evidence gaps and research needs

Special importance for the treatment of CKD should be attached to changes during the lifespan considering age, sex and gender for a personalized approach. To date there are no age or sex/gender-sensitive recommendations on the management of CKD. This aspect should be included in the next update.