Chronic kidney disease: assessment and management : guidance (NG203)

NICE Accredited

National Institute for Health and Care Excellence - NICE
Publication date:
25 August 2021


This guideline covers care and treatment for people with, or at risk of, chronic kidney disease (CKD). It aims to prevent or delay the progression, and reduce the risk of complications and cardiovascular disease. It also covers managing anaemia and hyperphosphataemia associated with CKD.

 NICE has produced a COVID-19 rapid guideline on chronic kidney disease. It recommends changes to usual practice to maximise the safety of patients and protect staff from infection during the COVID-19 pandemic.

In November 2021, we updated our guidance on SGLT2 inhibitors for adults with type 2 diabetes and chronic kidney disease. For the new recommendations, see managing chronic kidney disease in the NICE guideline on type 2 diabetes in adults.


This guideline was updated in August 2021. There are new and updated recommendations on:

These supplement the existing recommendations on:

See visual summaries on the recommendations for identifying CKD in adults, phosphate binders and managing proteinuria.

View identifying CKD in adults visual summary  View phosphate binders visual summary  View managing proteinuria visual summary

Who is it for?

  • Healthcare professionals
  • Commissioners and providers
  • People with chronic kidney disease, their families and carers

Is this guideline up to date?

We checked this guideline in August 2021 and propose to update the recommendation on oral antiplatelet therapy for reducing cardiovascular disease in people with chronic kidney disease.

We also checked this guideline in September 2021 to assess if it should be highlighted as a HIV indicator condition. We did not have clinical consensus, so will not amend this area but will note the issue for consideration in the future.

Guideline development process

How we develop NICE guidelines

This guideline updates and replaces NICE guidelines CG182 (published July 2014), NG8 (published June 2015), and CG157 (published March 2013).