[Brussels, Belgium] — Kidney Disease: Improving Global Outcomes (KDIGO) is pleased to announce the publication of the KDIGO 2026 Clinical Practice Guideline for Anemia in Chronic Kidney Disease (CKD), a comprehensive update to the KDIGO 2012 Anemia in CKD Guideline. The guideline, published today in Kidney International, provides evidence-based recommendations and practice points to inform the diagnosis, evaluation, and management of anemia in adults and children with CKD, including those treated with dialysis or kidney transplantation. The guideline was co-chaired by Jodie Babitt, MD (United States), and Marcello Tonelli, MD, SM, MSc, FRCPC (Canada).

Anemia is a common and burdensome complication of CKD, associated with reduced quality of life, increased cardiovascular risk, and a greater reliance on red blood cell transfusions. The updated guideline reflects advances in the understanding of anemia pathophysiology and treatment, and offers practical guidance across the full spectrum of CKD stages and care settings.

“This guideline represents a major step forward in how we approach anemia in CKD,” said Dr. Babitt. “It emphasizes a systematic evaluation of anemia and iron deficiency, clearer guidance on when and how to use oral and intravenous iron, and a more nuanced, individualized approach to anemia treatment that weighs symptoms, risks, and patient preferences. Importantly, the guideline integrates new evidence on emerging therapies while reinforcing the need to avoid overtreatment and to prioritize safety and shared decision-making.”

The KDIGO 2026 Anemia in CKD Guideline was developed using a rigorous, transparent methodology, including systematic reviews of the evidence and a formal assessment of the certainty of evidence using the GRADE approach.

“The updated Anemia in CKD Guideline reflects a decade of new evidence and the increasing complexity of anemia management in people with chronic kidney disease,” said Dr. Tonelli. “We evaluated a large body of randomized trial data across iron therapies, ESAs, HIF-PHIs, and transfusion strategies, with careful attention to both benefits and harms. Rather than promoting a single approach, the guideline supports individualized decision-making that considers symptoms, comorbidities, treatment risks, and patient preferences. By incorporating population-based treatment algorithms and practice points alongside graded recommendations, we aimed to support consistent, evidence-informed anemia care across diverse healthcare systems, resource settings, and patient populations worldwide.”