- Design
- KDIGO Controversies Conference report
- Population
- People with or at risk of chronic kidney disease
- Primary outcome
- Factors and research priorities for technology-supported guideline-informed care
- Effect
- Priorities: living guidelines, integrated decision support, equity, interoperability, health technology assessment
A KDIGO Controversies Conference in November 2025 examined how technology could improve the poor uptake of guideline-based care for people with or at risk of kidney disease, from detection and risk stratification to prescribing and self-management.
The report lists factors at the level of patients, clinicians, health systems, policy and the technology itself that determine whether digital tools help. Its research priorities include living guidelines, building guideline recommendations into clinical decision support, evidence that tools are safe and reduce rather than widen disparities, interoperability across systems, validated health technology assessment, and the value of sensor-derived biomarkers.
The immediate relevance is that most CKD is under-detected and under-treated, including in India, where diabetes and hypertension drive a large and largely unscreened burden. The simplest technology — an electronic prompt to test albuminuria in people with diabetes, or to start an SGLT2 inhibitor when criteria are met — remains the most likely to help now.
- Use electronic prompts or registers to test eGFR and urine albumin-creatinine ratio in people with diabetes or hypertension.
- Build CKD prescribing prompts, such as for RAS blockade and SGLT2 inhibitors, into clinic systems where possible.
- Check that any digital tool works for patients with limited literacy or connectivity.
- Treat decision-support tools as aids to guideline care, not replacements for clinical judgement.
Why it matters
The gap in CKD care is mostly in detection and prescribing, which simple tools can address.
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