Chronic kidney disease (CKD) has a significant global impact, affecting over 800 million people, particularly those from lower socio-economic backgrounds.¹ In Hong Kong, recent survey data indicate that 0.7% of individuals aged 15 and older have been diagnosed with renal impairment.¹ CKD is classified into five stages, with stages 4 and 5 linked to considerably higher risks of mortality and cardiovascular complications.¹ Early detection and intervention are crucial for preventing the progression to kidney failure and for effective risk stratification, especially since over 40% of individuals with diabetes—a major risk factor for CKD—are likely to develop the condition.¹ 

Despite the critical need for early identification and management of CKD, Hong Kong has yet to establish a consensus on best practices, and existing guidelines have not been widely adopted due to inadequate incentives.¹ To address this gap, the Management of CKD: A Hong Kong Consensus Recommendation was developed, offering practical guidance for local healthcare practitioners grounded in evidence and expert opinion.¹ An expert panel, including nephrologists, endocrinologists, and family medicine specialists, formulated these recommendations using a modified Delphi process.¹ 

The panel reviewed peer-reviewed literature on CKD published between January 2017 and September 2022, encompassing clinical trials, guidelines, and systematic reviews, to draft initial statements on the definition, screening, and management of CKD.¹ Each draft statement was evaluated using a 5-point Likert scale: A (fully accept), B (accept with minor reservations), C (accept with major reservations), D (reject with reservations), and E (fully reject).¹ Statements were revised as needed, followed by a second round of voting.¹ A consensus was achieved when at least 75% of panel members either fully accepted the statement or accepted it with reservations.1 Ultimately, 14 statements met this consensus threshold (table 1).¹