[Kidney diseases: News from the KDIGO guidelines]

Area of Science:

• Nephrology
• Clinical Practice Guidelines
• Evidence-Based Medicine

Context:

• The KDIGO Update 2024 incorporates new clinical practice points, building upon existing evidence.
• Significant revisions address induction therapy for lupus nephritis (classes III and IV) and ANCA-associated nephritis.
• An international consensus statement provides updated guidelines for blood pressure measurement validity.

Purpose:

• To summarize key changes and new recommendations from the KDIGO Update 2024.
• To highlight advancements in the treatment of lupus nephritis and ANCA-associated nephritis.
• To outline standardized procedures for accurate blood pressure measurement.

Summary:

• The 2024 KDIGO Update modifies induction therapy for lupus nephritis (classes III/IV) with high-dose glucocorticoids and hydroxychloroquine. For ANCA-associated nephritis, it incorporates Avacopan and reduced glucocorticoid protocols.
• New guidelines for blood pressure measurement establish 4 steps for validity.
• The Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) update is pending, but initial data aligns with 2017 guidelines, potentially re-evaluating calcium-containing phosphate binders.

Impact:

• Provides clinicians with updated evidence-based recommendations for managing complex kidney diseases.
• Enhances consistency and accuracy in clinical practice through standardized blood pressure measurement protocols.
• Informs ongoing research and clinical decision-making regarding nephritis and CKD-MBD management.