Zachary Sutton: Translating the 2026 KDIGO Guideline Into Practice
Zachary Sutton, Director of Medical Operations, Transplant Program Coordinator at Carolina Nephrology, PA, Adjunct Assistant Professor at Medical University of South Carolina, shared a post on LinkedIn about a recent article by Susan Hedayati et al, published in Annals of Internal Medicine, adding:
“The 2026 KDIGO anemia guideline updates how we manage anemia in CKD by emphasizing individualized treatment over a one-size-fits-all approach.
Key takeaways include:
- Use ferritin and TSAT to guide iron therapy, with IV iron preferred for patients on hemodialysis
- Address reversible causes of anemia before starting ESA or HIF-PHI therapy
- ESAs remain the preferred first-line therapy over HIF-PHIs
- Individualize when to initiate ESA therapy based on symptoms, comorbidities, and patient preferences
- Maintain hemoglobin below 11.5 g/dL during ESA treatment
For nephrology teams, the message is clear: treat the patient, not simply the hemoglobin number.
The updated guideline gives us a more personalized framework for balancing iron replacement, anemia symptoms, transfusion avoidance, and treatment risk across the CKD spectrum.
A useful update for anyone managing patients with advanced CKD or dialysis.”
Title: Evaluation and Management of Anemia in Chronic Kidney Disease: Synopsis of the Kidney Disease: Improving Global Outcomes 2026 Clinical Practice Guideline
Authors: S. Susan Hedayati, Jodie L. Babitt, Jeffrey S. Berns, Biykem Bozkurt, Rebecca S. Cheung, Yarieli Cuevas, Emmanuel E. Effa, Michele F. Eisenga, Steven Fishbane, Yelena Z. Ginzburg, Volker H. Haase, Siah Kim, Jose A. Moura-Neto, Patrick Rossignol, Manisha Sahay, Tetsuhiro Tanaka, Angela Yee-Moon Wang, David C. Wheeler, Karen A. Robinson, Lisa M. Wilson, Renée F. Wilson, Jennifer M. King, Amy Earley, Elie A. Akl, Marcello Tonelli, Evi V. Nagler
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