# Caring for Australians and New Zealanders with kidney Impairment guidelines commentary on the Kidney Disease: Improving Global Outcomes clinical practice guideline for management of diabetes and chronic kidney disease

## TL;DR

This paper provides a regional commentary on diabetes and CKD guidelines to better suit healthcare in Australia and New Zealand.

## Contribution

The paper offers a localized adaptation of international guidelines for diabetes and CKD management in Australia and New Zealand.

## Key findings

- International guidelines lack consideration for local healthcare systems in Australia and New Zealand.
- The commentary addresses medication access and equity for Indigenous populations.
- Shared decision-making is emphasized for locally relevant care.

## Abstract

Diabetes is a leading cause of kidney failure, and individuals with both diabetes and chronic kidney disease (CKD) experience significantly higher rates of complications and mortality. The international guideline developer Kidney Disease: Improving Global Outcomes (KDIGO) has produced clinical practice guidelines that reflect recent advances in pharmacotherapy for this population, extending beyond glycaemic control to include cardio‐renal benefits. However, these guidelines were developed without specific consideration of the healthcare systems, access issues and population needs in Australia and New Zealand. In response, the Caring for Australians and New Zealanders with Kidney Impairment (CARI) Guidelines Working Group has provided a regional commentary on the KDIGO 2022 guideline. This commentary highlights key recommendations and contextualises their implementation within the Australian and New Zealand healthcare environments. It addresses issues such as medication access, equity for Indigenous populations and the importance of shared decision‐making, aiming to support clinicians in delivering evidence‐based, locally relevant care for people living with diabetes and CKD.