Consensus Guidance for the Diagnosis and Management of Diabetic Kidney Disease: Executive Summary.
Kavita Yadav, Vivekanand Jha, Georgi Abraham, Alan Fernandes Almeida, Sandeep Bansal, Shyam Bihari Bansal, Dipankar Bhowmik, Sujoy Ghosh, Natarajan Gopalakrishnan, Sanjeev Gulati, Shashank R Joshi, Sanjay Kalra, Jothydev Kesavadev, Vijay Kher, Dinesh Khullar, Ajay Umakant Mahajan, V Mohan, Abraham Oomman, Sreejith Parameswaran, Uday Phadke, C K Ponde, Sathyanarayana Rao Prakash, Narayan Prasad, Sree Bhushan Raju, A Ramachandran, Manisha Sahay, Rakesh Kumar Sahay, Jps Sawhney, Bipin Kumar Sethi, Daljit Singh Sethi, Parag Shah, Raj Kumar Sharma, Shivendra Singh, Rajana Sreedhara, Mangesh Tiwaskar, Subhash K Wangnoo
Journal: The Journal of the Association of Physicians of India
2026;74(7E):e24-e29
PMID: 42543958
Abstract
Diabetic kidney disease (DKD) is becoming an increasingly common consequence of diabetes in India, where the number of affected individuals is rising at an alarming pace. The illness is often silent in its early stages, and many patients are diagnosed only when kidney damage is advanced, leading to high rates of kidney failure and cardiovascular complications. This consensus document was developed by a broad group of experts to provide practical, evidence-based recommendations tailored for Indian healthcare settings. It stresses the importance of timely screening using the urine albumin-to-creatinine ratio and estimated glomerular filtration rate, along with routine evaluation of cardiovascular risks. The guidance covers key management areas such as blood pressure and glycemic control, the use of renin-angiotensin system blockers, newer agents such as sodium-glucose cotransporter 2 inhibitors (SGLT2) inhibitors and finerenone, as well as lifestyle and dietary measures. Equal attention is given to affordability, patient education, and integrating care into national health programs. By adapting international standards to local realities, this document aims to improve early detection, reduce inequalities in treatment, and support better long-term outcomes for people living with DKD in India.
© Journal of the Association of Physicians of India 2026.
Address:
Research Fellow, George Institute for Global Health, New Delhi, India.; Executive Director, George Institute, New Delhi, India; Chair of Global Kidney Health, Faculty of Medicine, Imperial College, London; Conjoint Professor, Department of Medicine, University of New South Wales, Sydney, Corresponding Author.; Academic Director & Senior Consultant Nephrologist, MGM Healthcare PVT LTD, Chennai, Tamil Nadu, India.; Consultant & Head of Section(Nephrology), PD Hinduja National Hospital & Research Centre, Mumbai, Maharashtra, India.; Ex HOD Cardiology, Curretly Medical Supritendent, Vardhman Mahavir Medical College & Safdarjang Hospital, New Delhi, India.; Senior Director & HOD Nephrology, Kidney Transplant Medanta Hospital, Gurugram, Haryana, India.; Professor, Department of Nephrology, AIIMS, Delhi, India.; Professor, Department of Endocrinology and Metabolism, Institute of Post Graduate Medical Education & Research, Kolkata, West Bengal, India.; Member Secretary, Transplant Authority, Tamil Nadu, India.; Executive Director and Head, Department of Nephrology, Fortis Hospitals, Vasant Kunj, New Delhi, India.; Department of Endocrinology, Joshi Clinic, Mumbai, Maharashtra, India.; Consultant Endocrinologist & Head, Bharti Hospital, Karnal, Haryana, India.; Chairman & Managing Director, Jothydev's Diabetes Research Center, Kerala, India.; Chairman, Epitome Kidney and Urology Institute and Lions Hospital, New Delhi, India.; Chairman, Department of Nephrology & Renal Transplant Medicine, Max Super Speciality Hospital, Saket, New Delhi, India.; Professor & Head of Department, King Edward Memorial Hospital, Mumbai, Maharashtra, India.; Chairman & Consultant, Dr. Mohan's Diabetes Specialities Centre, Chennai, Tamil Nadu, India.; Senior Consultant Cardiologist & HF Specialist, Apollo Hospital, Chennai, Tamil Nadu, India.; Professor & Head, Department of Nephrology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.; HOD, Department of Endocrinology, Sahyadri Hospital, Pune, Maharashtra, India.; Professor & HOD, Department of Cardiology, PD. Hinduja National Hospital, Mahim, Mumbai, Maharashtra, India.; Professor & HOD, Department of Cardiology & Cardiac Physiology, MSR Ramaiah Hospital, Bengaluru, Karnataka, India.; Professor and Head of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.; Senior Professor & Head (Unit II), Department of Nephrology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.; Chairman, Dr. A. Ramachandran's Diabetes Hospitals, Chennai, Tamil Nadu, India.; Professor and Head, Department of Nephrology, Osmania Medical College & Osmania General Hospital, Hyderabad; Consultant Nephrologist, Aditya Hospital, Hyderabad, Telangana, India.; Professor, Department of Endocrinology, Osmania Medical College & Hospital; Consultant Endocrinologist, Sahay's Endocrine & Diabetes Centre, Ameerpet, Hyderabad, Telangana, India.; Sr. Consultant & Chairman, Department of Cardiology, Sir Ganga Ram Hospital, New Delhi, India.; Consultant Endocrinologist and HOD, Care Hospitals, Banjara Hills, Hyderabad, Telangana, India.; Director, Hope Clinic, Shillong, Meghalaya, India.; Consulting Diabetologsit & Endocrinologist, Gujrat Endocrine Centre, Ahmedabad, Gujrat, India.; Director & Head Department of Nephrology, & Kidney Transplant Medicine, Medanta Kidney & Urology Institute, Lucknow, Uttar Pradesh, India.; Professor and Head of Department, Department of Nephrology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.; Consultant Nephrologist, Bangalore & Fortis Hospital, Bengaluru, Karnataka, India.; Consultant Physician and Diabetologist, Consultant Physician and Diabetologist, Shilpa Medical Research Centre, Mumbai, Maharashtra, India.; Senior Consultant Endocrinologist and Diabetologist, Apollo Centre for Obesity, Diabetes and Endocrinology, Indraprastha Apollo Hospital, New Delhi, India.
