- Design
- KDIGO Controversies Conference consensus report
- Population
- People with or at risk of kidney disease, and the health systems serving them
- Primary outcome
- Barriers and research priorities for technology-supported care
- Effect
- Priorities: living guidelines, decision support, equity, interoperability, assessment
A KDIGO Controversies Conference held in November 2025 examined how technology, from electronic health record alerts and risk calculators to clinical decision support and remote monitoring, can close the gap between kidney guidelines and what patients actually receive.
The report identifies barriers at patient, clinician, health system and policy levels, and sets research priorities: living guidelines that update continuously, decision support built from harmonised recommendations, evidence that tools are safe and reduce rather than widen disparities, interoperability across systems, and proper health technology assessment.
This is a consensus report, not a trial. Its relevance to a nephrologist today is a checklist: much of the undertreatment of CKD, such as missing albuminuria testing or unused SGLT2 inhibitors, is a systems problem that alerts and registries can address, but only if they are evaluated rather than assumed to work.
- Use laboratory flags or registries to identify patients with CKD who lack albuminuria testing.
- Audit SGLT2 inhibitor and RAS blocker use among eligible CKD patients in your service.
- Evaluate any new decision support tool for its effect on prescribing before relying on it.
- Check that digital tools work for patients with limited literacy or connectivity.
Why it matters
The commonest failures in CKD care are omissions that systems, not individual clinicians, can fix.
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