KDIGO 2026 Clinical Practice Guideline for the Management of Anemia in Chronic Kidney Disease (CKD). Translated into Russian by K.A. Vishnevskii, V.Yu. Ryasnyanskii and A.Yu. Zemchenkov, edited by K.A. Vishnevskii

Abstract

The Kidney Disease: Improving Global Outcomes (KDIGO) 2026 Clinical Practice Guideline for the Management of Anemia in Chronic Kidney Disease (CKD) is an update of the KDIGO 2012 guideline on the topic. The guideline informs the care of adults and children with anemia and CKD, whether receiving kidney replacement therapy or not. The guideline includes chapters dedicated to diagnosis and evaluation of anemia in CKD, use of iron to treat iron deficiency and anemia in people with CKD, use of erythropoiesis-stimulating agents, hypoxiainducible factor–prolyl hydroxylase inhibitors, and other agents to treat anemia in people with CKD, and red blood cell transfusions to treat anemia in people with CKD. New nomenclature is proposed to define different states of iron deficiency, replacing “absolute iron deficiency” with “systemic iron deficiency” and “functional iron deficiency” with “iron-restricted erythropoiesis” to more accurately reflect the pathophysiological state. The update considers evidence from randomized controlled trials published through October 2024. The guideline provides actionable recommendations based on a rigorous formal evidence review with practice points and supporting infographics to aid in the implementation of guideline recommendations. The target audience for the guideline includes providers involved in the care of people with anemia and CKD as well as people with anemia and CKD themselves. Development of this guideline followed an explicit process of evidence review and appraisal. The guideline recommendations are based on systematic reviews of relevant studies and appraisal of the certainty of evidence and strength of the recommendations following the “Grading of Recommendations Assessment, Development and Evaluation” (GRADE) approach. Limitations of the evidence are discussed, and suggested areas for future research are also presented.