KDIGO Life Cycle of Guideline Development Series Part 2: From Initiation to Publication: the KDIGO Guideline Development Process.

Sarwal, Amara; Oliveras, Laia; Lazarus, Benjamin; Nesrallah, Gihad; Carmona, Chris; Vernooij, Robin; Akl, Elie; Edeki, Imuetinyan et al. · Kidney Int · 2026

other · Level V

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Abstract

Guidelines play a critical role in translating evidence into consistent, transparent, and actionable recommendations to inform clinical practice, policy, and decision-making. Nevertheless, heterogeneity in guideline development methodology has raised concerns regarding applicability and implementation. In this paper, we describe the structured and systematic guideline development process employed by Kidney Disease: Improving Global Outcomes (KDIGO), which is designed to enhance methodological rigor, transparency, and stakeholder confidence. This paper outlines the process from initiating a guideline and appointing Guideline Work Group Co-Chairs to assembling the full team, including Guideline Work Group members, the Evidence Review team, Methods Committee representatives, and the KDIGO Guideline team. We also outline the guideline development timeline until publication and dissemination, public review opportunities, and the rigorous disclosure of interest management process. By delineating a transparent and reproducible guideline development process, this paper aims to support the production of high-quality KDIGO guidelines that are evidence-based, credible, and implementable across diverse settings.