Chronic kidney disease in adults: assessment and management – NICE guideline

Produced by:

This National Institute for Health and Care Excellence (NICE) guideline covers the care and treatment of people with, or at risk of developing, chronic kidney disease. It aims to prevent or delay the progression of chronic kidney disease, reduce or prevent the development of complications, and reduce the risk of cardiovascular disease.

Chronic kidney disease (CKD) describes abnormal kidney function and/or structure. It is common, frequently unrecognised and often exists together with other conditions (such as cardiovascular disease and diabetes). Moderate to severe CKD is also associated with an increased risk of other significant adverse outcomes such as acute kidney injury, falls, frailty and mortality. The risk of developing CKD increases with age. As kidney dysfunction progresses, some coexisting conditions become more common and increase in severity. CKD can progress to end-stage kidney disease in a small but significant percentage of people.

CKD is usually asymptomatic, but it is detectable, and tests for CKD are simple and freely available. There is evidence that treatment can prevent or delay the progression of CKD, reduce or prevent the development of complications, and reduce the risk of cardiovascular disease. However, CKD is often unrecognised because there are no specific symptoms, and it is often not diagnosed or diagnosed at an advanced stage.

The recommendations in this guideline cover:

  • investigations for CKD
  • classification of CKD
  • frequency of monitoring
  • information and education
  • referral criteria
  • pharmacotherapy
  • other complications.

New and updated areas include:

  • identification and investigation of people who have or are at risk of developing CKD
  • classification of CKD and identification of people at risk of CKD complications and progression
  • the definition of CKD progression
  • the relationship between acute kidney injury and CKD
  • self-management of CKD
  • pharmacotherapy for CKD.

You can read the guideline on NICE's website.