Many guidance-providing documents have been produced on the management of patients with diabetes to prevent or delay the progression to CKD, mostly defined as the presence of micro and macro-albuminuria. However, none of these documents specifically deal with the management of the patients with CKD stage 3b or higher (eGFR <45ml/dk/1.73m2). There is a paucity of well-designed, prospective studies in this population, as many studies exclude either patients with diabetes, or with CKD stage 3b or higher (eGFR <45ml/dk/1.73m2), or both. This limits the evidence base to these approaches. The advisory board of ERBP decided that a guideline on the management of patients with diabetes and CKD stage 3b or higher (eGFR <45ml/dk/1.73m2) was needed. In addition to a rigorous approach to methodology and evaluation, we are keen to ensure that the document focused on patient-important outcomes and utility for clinicians involved in everyday practice.