Chronic kidney disease affects around one in ten people worldwide, and roughly half of those living with type 2 diabetes or heart failure. Effective disease-modifying therapies exist and are recommended in guidelines, yet real-world prescribing consistently falls short of that guidance, and care is split across several specialties that do not always align.
To close the gap, an international steering group spanning nephrology, diabetes, internal medicine and primary care developed 42 statements covering the pathway from screening to complications. The statements were tested through a modified Delphi consensus, with a survey completed by 274 clinicians across 11 countries. Consensus was pre-specified at 75% agreement, with very high agreement set at 90%.
All 42 statements reached consensus, 37 of them at very high agreement. The 12 recommendations set clear priorities: early screening of high-risk groups using eGFR and urine albumin-to-creatinine ratio, early intervention with SGLT2 inhibitors and RAASi therapies, and integrating primary care physicians into multidisciplinary management.
Triducive acted as the independent facilitator for this modified Delphi consensus, generating the statements and analysing the responses. The strong cross-specialty agreement gives clinicians a shared basis for identifying and managing chronic kidney disease earlier.
Arici M, et al. BMJ Open, 2024; 14(3): e080891. DOI: 10.1136/bmjopen-2023-080891
