2025 Taiwan consensus recommendations for primary care of chronic kidney disease

Chronic kidney disease (CKD) is a major public health challenge in Taiwan, projected to affect over three million people by 2027. Despite national Pay-for-Performance programs, gaps in early detection and risk control call for practical, standardized primary care strategies. To address this, a core group of experts systematically reviewed international and local CKD guidelines and relevant literature, with emphasis on applicability to Taiwan's health system and frontline practice, and drafted preliminary recommendations. A multidisciplinary panel comprising representatives from nephrology, endocrinology, cardiology, family medicine, nursing, nutrition, pharmacy, public health, and government reviewed, discussed, and voted on each recommendation through a formal consensus. Consensus was defined as ≥70 % agreement, with ≥90 % indicating strong consensus. Ten recommendations were endorsed, nine with strong consensus and one achieved consensus. The framework emphasizes risk-based and age-stratified screening, combined eGFR and albuminuria testing for diagnosis, and staging with the G/A classification system. Preventive measures include kidney health literacy promotion and management of modifiable risk factors. In Taiwan, CKD care is embedded within National Health Insurance-supported Pay-for-Performance programs that combine multidisciplinary management to delay disease progression, reduce cardiorenal complications, prolong survival, and improve quality of life. Recommendations also highlight patient self-management, individualized targets for blood pressure, glycemic control, and lipid management, cornerstone therapies with angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEis/ARBs) and sodium-glucose cotransporter 2 inhibitor (SGLT2i), and timely nephrology referral. The 2025 Taiwan CKD Care Consensus provides evidence-based and locally tailored guidance to strengthen primary care and multidisciplinary collaboration, improving outcomes and sustaining healthcare delivery.