Ask the Doctor
Questions about kidney disease? Risk factors? Signs and symptoms? Are you concerned about yourself, a friend or family member? Ask Dr. Spry.
New York, NY
April 9 , 2001
The National Kidney Foundation (NKF) has convened a work group to develop clinical practice guidelines for management of lipid abnormalities in transplant recipients. The guidelines are the most recent addition to NKF's comprehensive Kidney Disease Outcomes Quality Initiative (K/DOQI). This expert group of scientists and medical professionals will conduct an extensive structured review of the literature related to cardiovascular disease and dyslipidemias in patients with kidney failure.
These guidelines are part of NKF's major effort to create clinical practice guidelines to improve the cardiovascular outcomes of individuals at all stages of kidney disease, from its earliest indications through the need for dialysis or transplantation. The effort will encompass recommendations on hypertension, left ventricular hypertrophy and dyslipidemias.
The work of these experts will build on the recommendations of an NKF Task Force on Cardiovascular Disease (CVD), which concluded that CVD has reached epidemic proportions among patients with kidney disease.
The relationship between dyslipidemias and cardiovascular disease has been best studied in kidney transplant recipients.
"Although there are more than 100,000 kidney transplant recipients alive today in the United States — testimony to the success of this procedure — cardiovascular disease, not graft failure, remains the leading cause of death among these patients," says Bertram L. Kasiske, MD, professor of medicine at the University of Minnesota and work group chair. "The work group will first consider which of the many possible prevention and management strategies might be most suitable for evidenced - based guideline development. This decision will be based on the amount of clinical evidence that is available," Dr. Kasiske adds. The group's vice chair is Fernando Cosio, MD, professor of internal medicine and pathology at The Ohio State University School of Medicine.
Evidence for these guidelines will be based on studies documenting: the incidence of CVD in target populations, the strength of the association between risk factors and CVD in these target populations and the efficacy and safety of therapies (including immunosuppressive strategies) that modify those risk factors.
Other evidence will come from studies targeting specific prevention strategies in both the general public and in patients with kidney failure. Although the work group will concentrate on strategies and outcomes specific to kidney transplant recipients, where the preponderance of evidence is available, their findings may have relevance for recipients of other transplanted organs as well.
Once the guidelines are completed, they will be subjected to the three-stage review process which has become the signature of the K/DOQI initiative and includes review by the K/DOQI Advisory Board, organizations involved in the care of patients, and hundreds of individual experts.
The development of the guidelines is made possible by an unrestricted grant by Fujisawa Healthcare, Inc.
"We are grateful to Fujisawa for supporting the development of these guidelines," says Garabed Eknoyan, MD, K/DOQI co-chair. "Our experience has shown us that practice guidelines developed using the original DOQI principles of rigor, interdisciplinary approach, work group independence and openness can significantly improve the clinical outcomes of patients."
The National Kidney Foundation is dedicated to preventing kidney and urinary tract diseases, improving the health and well-being of individuals and families affected by these diseases and increasing the availability of all organs and transplantation.