2025 Volume 52 Issue 2 Pages 362-369
Chronic kidney disease (CKD) is recognized not only as a leading cause of end-stage renal disease (ESRD) but also as a risk factor for the development and mortality of cardiovascular disease (CVD). In Japan, the number of chronic dialysis patients is higher compared to other countries, and the aging population is expected to further increase the prevalence of CKD, making it a critical healthcare issue. Clinical practice guidelines have played a pivotal role in the dissemination and promotion of CKD care. In 2002, the KDOQI (National Kidney Foundation's Kidney Disease Outcomes Quality Initiative) published guidelines on the diagnosis and management of CKD, which were later succeeded by KDIGO (Kidney Disease: Improving Global Outcomes).
The Japanese Society of Nephrology (JSN) published the "CKD Clinical Guide" in 2007 as a tool for collaboration between primary care physicians and specialists. This guide was revised in 2009 and 2012. In 2009, JSN released the "Evidence-Based CKD Clinical Practice Guidelines" targeting nephrologists, and in 2013, a revised version adopting the CQ (clinical question)-based format was published. Subsequently, in 2018, the "CKD Clinical Practice Guidelines" were comprehensively revised with non-specialists in mind, and a "CKD Care Guide for Patients and Their Families" was also introduced.
The "Evidence-Based CKD Clinical Practice Guidelines 2023" feature a significant update, combining text-based explanations that include expert opinions with CQ-based content. In response to concerns about the volume of information, simplified versions, namely the "CKD Clinical Guide 2024" for non-specialists and medical staff and the "CKD Care Guide 2024" for patients and their families, were also developed. These initiatives aim to clarify the role of the "CKD Clinical Practice Guidelines 2023," facilitating early detection of CKD, strengthening care coordination, and slowing disease progression. These efforts are expected to reduce the incidence of CVD and dialysis initiation while promoting public health.
