Managing Advanced Diabetic Kidney Disease in the UAE: National Consensus Recommendations for Dialysis, Transplantation, and Emergencies

Abstract Diabetic kidney disease (DKD) is the leading cause of end-stage kidney disease (ESKD) in the UAE, contributing substantially to cardiovascular morbidity and mortality. To provide UAE-specific expert recommendations for managing advanced DKD, including stage 5 disease, dialysis, transplantation, and post-transplant metabolic complications. A multidisciplinary panel of 14 UAE nephrology and endocrinology experts used a Modified Mini-Delphi process to adapt international guidelines (ADA, KDIGO, NICE, UAE Cardiometabolic) to regional clinical practice. Consensus was defined as ≥80% agreement. Recommendations emphasize individualized glycemic and blood pressure control during dialysis, early recognition and treatment of post-transplant diabetes, and targeted management of DKA and hyperosmolar states in dialysis patients. Integration of SGLT2 inhibitors, GLP-1 receptor agonists, and multidisciplinary digital care models was endorsed. These UAE consensus recommendations provide unified, evidence-based guidance for advanced DKD management, forming a nationwide framework to prioritize lives through standardized care and education.