A Pivotal Update for AKI Care: KDIGO Opens 2026 Draft Guideline for Public Review
The first major revision since 2012 expands the framework to include Acute Kidney Disease and integrates biomarkers into updated definitions. Public comment closes April 27, 2026.
A generational update for kidney care
After more than a decade, KDIGO (Kidney Disease: Improving Global Outcomes) has released the draft of its 2026 Clinical Practice Guideline for Acute Kidney Injury (AKI) and Acute Kidney Disease (AKD). This is the first substantial update since 2012, and it reflects how significantly the field has evolved in that time.
The draft introduces an expanded framework that encompasses both AKI and AKD, recognizing the continuum of kidney injury, recovery, and ongoing risk of chronic kidney disease. Key updates include:
- Revised definitions that integrate functional criteria with structural biomarkers, supporting earlier and more precise diagnosis
- Increased emphasis on risk prediction, early identification, and prevention
- New and revised recommendations on validated risk models, biomarkers, electronic alerts, fluid and hemodynamic management, drug and nephrotoxin stewardship, and contrast-associated AKI
- Updated kidney replacement therapy guidance, including timing, modality, dosing, and discontinuation
- Follow-up care recommendations after AKI or AKD to reduce long-term adverse outcomes
- Pediatric and neonatal considerations, alongside implementation guidance for diverse global settings
Recommendations were developed by an international Work Group — which included patient representatives — using the GRADE methodology to ensure transparency in recommendation strength and evidence certainty.
Why this matters
For a decade, the AKI community has watched the evidence base mature — particularly around biomarker-informed early detection, risk stratification, and post-AKI follow-up. The 2026 draft brings these threads together in a single, rigorous framework.
At BioPorto, we see this update as a meaningful step toward a goal we’ve long worked toward: making kidney injury easier to recognize earlier, so clinicians can act sooner and patients experience better outcomes. The draft’s integration of structural biomarkers and its expanded attention to risk prediction reflect where we believe the field is headed — and where it needs to go.
Your feedback helps shape the final guideline
KDIGO welcomes input from clinicians, researchers, and other stakeholders. Reviewers are encouraged to focus on the sections most relevant to their expertise. By submitting comments, you agree that KDIGO may acknowledge your contribution as a reviewer in the final publication.
The public review period closes April 27, 2026.