January 2026 brought important news for people living with chronic kidney disease (CKD).
The U.S. Department of Veterans Affairs (VA) and the Department of Defense (DoD) released an updated clinical guideline that puts a strong focus on using medications earlier to slow kidney damage and protect the heart—especially in the early stages of CKD.

The guideline, published in Annals of Internal Medicine, is designed not just for kidney specialists, but also for primary care doctors, who often manage CKD long before patients ever see a nephrologist.*

The big message: early detection + the right medications can change the course of kidney disease.

Why This Update Matters

CKD is linked to:

• Higher risk of heart disease
• Shorter life expectancy
• Lower quality of life

Yet many people with CKD don’t know they have it until it’s advanced.

According to the guideline authors, earlier testing and earlier treatment can:

• Slow kidney damage
• Reduce heart attacks and strokes
• Lower the risk of dialysis or transplant later on

The Biggest Shift: Medications That Protect Kidneys and the Heart

About half of the updated recommendations focus on medications—reflecting major advances over the past few years.

1. Blood Pressure Medications Still Matter (ACE inhibitors & ARBs)

If you have high blood pressure and protein in your urine, the guideline strongly recommends:

• ACE inhibitors (ACEIs) or
• ARBs (angiotensin receptor blockers)

These medications help:

• Lower urine protein
• Slow kidney damage
• Protect the heart

Important update: Even in advanced CKD, these medications should usually be continued unless side effects occur. Stopping them too early can speed up kidney decline.

2. SGLT2 Inhibitors: A Game Changer for CKD

SGLT2 inhibitors (often called “flozins”) are now a cornerstone of CKD care.

They are recommended for people with CKD who have:

• Type 2 diabetes
• Protein in the urine
• Heart failure

These medications have been shown to:

• Slow kidney disease progression
• Reduce heart failure and heart attacks
• Lower the risk of death

They are recommended on top of ACEIs or ARBs and are typically continued until dialysis starts.

3. GLP-1 Medications: More Than Weight Loss

GLP-1 receptor agonists (like semaglutide or liraglutide) are now recognized for their kidney and heart benefits, not just blood sugar or weight control.

For people with:

• Type 2 diabetes
• Protein in the urine

Adding a GLP-1 medication can:

• Slow kidney disease
• Reduce heart complications
• Lower overall mortality

The guideline notes that SGLT2 inhibitors are usually tried first, but GLP-1 medications are an important option—especially when additional protection is needed.

4. A Special Case: Polycystic Kidney Disease (ADPKD)

For people with autosomal dominant polycystic kidney disease (ADPKD):

• Early referral to a kidney specialist is recommended
• The medication tolvaptan may be considered in certain patients

While it has side effects, it is currently the only treatment shown to slow cyst growth in people with rapidly progressing ADPKD—especially when started early.

Other Important Recommendations You Should Know

• Contrast scans (CT scans with dye):
  IV fluids before the scan help protect the kidneys
  ❌ N-acetylcysteine is not recommended—it doesn’t help

• Tracking kidney health:
  Doctors should use both eGFR and urine albumin (UACR)
  Together, these give a clearer picture of risk and progression

Screening: Catching CKD Earlier

Although routine CKD screening hasn’t been recommended for everyone, this guideline supports testing people at higher risk, including those with:

• Diabetes
• High blood pressure
• Heart disease
• Metabolic syndrome

The goal is simple: find CKD early enough to treat it effectively.

What This Means for You

If you live with CKD, this guideline reinforces an important truth:

Kidney disease is no longer “watch and wait.”
There are now multiple medications that can actively slow damage and protect your future.

Talk with your healthcare provider about:

• Whether you’re on the right combination of medications
• Whether newer options like SGLT2 inhibitors or GLP-1 medications make sense for you
• How often your urine protein and kidney function are being checked

Earlier action can mean more years with healthier kidneys—and fewer people needing dialysis or transplant.

*Medscape. (January 12, 2026). “Updated CKD Management Guideline Focuses on Pharmacotherapy. “medscape.com

To ensure that we always provide you with high-quality, reliable information, Responsum Health closely vets all sources. We do not, however, endorse or recommend any specific providers, treatments, or products, and the use of a given source does not imply an endorsement of any provider, treatment, medication, procedure, or device discussed within.