NKF KDOQI Guidelines

K/DOQI Update 2000

		NKF KDOQI GUIDELINES 2000

NKF-KDOQI Clinical Practice Guidelines General Acknowledgements NKF-DOQI Steering Committee KDOQI Support Group KDOQI Advisory Board KDOQI Co-Chairs and Work Groups' Membership Foreword Disclaimer I. NKF-KDOQI CLINICAL PRACTICE GUIDELINES FOR HEMODIALYSIS ADEQUACY: UPDATE 2000 Acronyms and Abbreviations Introduction I. Measurement of Hemodialysis Adequacy Guideline 1: Regular Measurement of the Delivered Dose of Hemodialysis Guideline 2: Method of Measurement of Delivered Dose of Hemodialysis Guideline 3: Uniformity of Method of Measurement II. Hemodialysis Dose Guideline 4: Minimum Delivered Dose of Hemodialysis Guideline 5: Prescribed Dose of Hemodialysis Guideline 6: Frequency of Measurement of Hemodialysis Adequacy III. Blood Urea Nitrogen (BUN) Sampling Guideline 7: Blood Urea Nitrogen (BUN) Sampling Guideline 8: Acceptable Methods for BUN Sampling Guideline 9: Standardization of BUN Sampling Procedure IV. Hemodialyzer Reprocessing and Reuse Guideline 10: Use of the Association for the Advancement of Medical Instrumentation (AAMI) Standards and Recommended Practices for Hemodialyzer Reprocessing Guideline 11: Baseline Measurement of Total Cell Volume Guideline 12: Monitoring Total Cell Volume Guideline 13: Minimum Required Total Cell Volume V. Hemodialysis Dose Troubleshooting Guideline 14: Inadequate Delivery of Hemodialysis VI. Maximizing Patient Adherence to the Hemodialysis Prescription Guideline 15: Optimizing Patient Comfort and Adherence Guideline 16: Strategies to Minimize Hypotensive Symptoms VII. References VIII. Appendices A: RPA Guideline Ordering Information B: Kinetic Determination of the Urea Distribution Volume C: Anthropometric Determination of the Urea Distribution Volume D: Contribution of Residual Kidney Function on Clearance With Thrice Weekly Dialysis Therapy E: Detailed Error Analysis for Deficiencies in Delivered Kt/V or URR F: Performance of Hydraulic Compression Test During Hemodialysis IX. Biographical Sketches of the NKF-KDOQI Hemodialysis Adequacy Work Group Members II. NKF-KDOQI CLINICAL PRACTICE GUIDELINES FOR PERITONEAL DIALYSIS ADEQUACY: UPDATE 2000 Acronyms and Abbreviations Introduction I. Initiation of Dialysis Guideline 1: When to Initiate Dialysis Kt/Vurea Criterion Guideline 2: Indications for Renal Replacement Therapy II. Measures of Peritoneal Dialysis Dose Guideline 3: Frequency of Delivered PD Dose and Total Solute Clearance Measurement Within Six Months of Initiation Guideline 4: Measures of PD Dose and Total Solute Clearance Guideline 5: Frequency of Measurement of Kt/Vurea, Total CCr, PNA, and Total Creatinine Appearance Guideline 6: Assessing Residual Kidney Function Guideline 7: PD Dose Troubleshooting III. Measurement of Peritoneal Dialysis Dose Guideline 8: Reproducibility of Measurement Guideline 9: Estimating Total Body Water and Body Surface Area Guideline 10: Timing of Measurement Guideline 11: Dialysate and Urine Collections IV. Assessment of Nutritional Status Specifically as It Relates to Peritoneal Dialysis Guideline 12: Assessment of Nutritional Status Guideline 13: Determining Fat-Free, Edema-Free Body Mass Guideline 14: Use of the Modified Borah Equation to Assess Nutritional Status of Pediatric PD Patients V. Adequate Dose of Peritoneal Dialysis Guideline 15: Weekly Dose of CAPD Guideline 16: Weekly Dose of NIPD and CCPD Guideline 17: PD Dose in Subpopulations Guideline 18: Use of Empiric and Computer Modeling of PD Dose VI. Strategies for Increasing the Likelihood of Achieving the Prescribed Dose of Peritoneal Dialysis Guideline 19: Identify and Correct Patient-Related Failure to Achieve Prescribed PD Dose Guideline 20: Identify and Correct Staff-Related Failure to Achieve Prescribed PD Dose VII. Clinical Outcome Goals for Adequate Peritoneal Dialysis Guideline 21: Measurement of PD Patient Survival Guideline 22: Measurement of PD Technique Survival Guideline 23: Measurement of Hospitalizations Guideline 24: Measurement of Patient-Based Assessment of Quality of Life Guideline 25: Measurement of School Attendance, Growth, and Developmental Progress in Pediatric PD Patients Guideline 26: Measurement of Albumin Concentration in PD Patients Guideline 27: Measurement of Hemoglobin/Hematocrit in PD Patients Guideline 28: Measurement of Normalized PNA in PD Patients VIII. Suitable Patients for Peritoneal Dialysis Guideline 29: Indications for PD Guideline 30: Absolute Contraindications for PD Guideline 31: Relative Contraindications for PD Guideline 32: Indications for Switching from PD to HD IX. References X. Appendices A: Detailed Rationale for Guideline 1 B. C: Detailed Rationale for Guideline 6 D: Detailed Rationale for Guideline 8 E: Detailed Rationale for Guideline 9 F: Detailed Rationale for Guideline 12 G: Detailed Rationale for Guideline 15 H: Detailed Rationale for Guideline 19 XI. Biographical Sketches of the NKF-KDOQI Peritoneal Dialysis Adequacy Work Group Members III. NKF-KDOQI CLINICAL PRACTICE GUIDELINES FOR VASCULAR ACCESS: UPDATE 2000 Acronyms and Abbreviations Introduction I. Patient Evaluation Prior to Access Placement Guideline 1: Patient History and Physical Examination Prior to Permanent Access Selection Guideline 2: Diagnostic Evaluation Prior to Permanent Access Selection Guideline 3: Selection of Permanent Vascular Access and Order of Preference for Placement of AV Fistulae Guideline 4: Type and Location of Dialysis AV Graft Placement Guideline 5: Type and Location of Tunneled Cuffed Catheter Placement Guideline 6: Acute Hemodialysis Vascular Access—Noncuffed Catheters Guideline 7: Preservation of Veins for AV Access Guideline 8: Timing of Access Placement Guideline 9: Access Maturation II. Monitoring, Surveillance, and Diagnostic Testing Guideline 10: Definition of Terms Guideline 11: Monitoring Primary AV Fistulae for Stenosis Guideline 12: Recirculation Methodology, Limits, Evaluation, and Follow-Up III. Prevention of Complications: Infection Guideline 13: Infection Control Measures Guideline 14: Skin Preparation Technique for Permanent AV Accesses Guideline 15: Catheter Care and Accessing the PatientÌs Circulation IV. Management of Complications: When to Intervene Guideline 16: Managing Potential Ischemia in a Limb Bearing an AV Access Guideline 17: When to Intervene—Dialysis AV Grafts for Venous Stenosis, Infection, Graft Degeneration, and Pseudoaneurysm Formation Guideline 18: When to Intervene—Primary AV Fistulae V. Management of Complications: Optimal Approaches for Treating Complications Guideline 19: Treatment of Stenosis Without Thrombosis in Dialysis AV Grafts and Primary AV Fistulae Guideline 20: Treatment of Central Vein Stenosis Guideline 21: Treatment of Thrombosis and Associated Stenosis in Dialysis AV Grafts Guideline 22: Treatment of Thrombosis in Primary AV Fistulae Guideline 23: Treatment of Tunneled Cuffed Catheter Dysfunction \|Guideline 24: Treatment of Infection of Dialysis AV Grafts Guideline 25: Treatment of Infection of Primary AV Fistulae Guideline 26: Treatment of Infection of Tunneled Cuffed Catheters Guideline 27: Treatment of Pseudoaneurysm of Dialysis AV Grafts Guideline 28: Aneurysm of Primary AV Fistulae VI. Potential Quality of Care Standards Guideline 29: Goals of Access Placement—Maximizing Primary AV Fistulae Guideline 30: Goals of Access Placement—Use of Catheters for Chronic Dialysis Guideline 31: Center-Specific Thrombosis Rate Guideline 32: Infection Rate Guideline 33: Primary Access Failure Rate—AV Grafts Guideline 34: Primary Access Failure Rate—Tunneled Cuffed Catheters Guideline 35: Primary Access Failure—Native AV Fistulae Guideline 36: Cumulative Patency Rate of Dialysis AV Grafts Guideline 37: Cumulative Patency Rate of Tunneled Cuffed Catheters Guideline 38: Cumulative Patency Rate of Primary AV Fistulae VII. References VIII. Biographical Sketches of the NKF-KDOQI Vascular Access Work Group Members IV. NKF-KDOQI CLINICAL PRACTICE GUIDELINES FOR ANEMIA OF CHRONIC KIDNEY DISEASE: UPDATE 2000 Acronyms and Abbreviations Introduction I. Anemia Work-Up Guideline 1: When to Initiate the Work-Up of Anemia Guideline 2: Anemia Evaluation Guideline 3: Erythropoietin Deficiency II. Target Hemoglobin/Hematocrit Guideline 4: Target Hemoglobin/Hematocrit for Epoetin Therapy III. Iron Support Guideline 5: Assessment of Iron Status Guideline 6: Target Iron Level Guideline 7: Monitoring Iron Status Guideline 8: Administration of Supplemental Iron Guideline 9: Administration of a Test Dose of IV Iron Guideline 10: Oral Iron Therapy IV. Administration of Epoetin Guideline 11: Route of Administration of Epoetin Guideline 12: Initial Epoetin Administration Guideline 13: Switching From Intravenous to Subcutaneous Epoetin Guideline 14: Strategies for Initiating and Converting to Subcutaneous Epoetin Administration Guideline 15: Monitoring of Hemoglobin/Hematocrit During Epoetin Therapy Guideline 16: Titration of Epoetin Dosage Guideline 17: Inability to Tolerate Subcutaneous Epoetin; IV Epoetin Dose Guideline 18: Intraperitoneal Epoetin Administration Guideline 19: Epoetin Dosage Perioperatively or During Intercurrent Illness V. Inadequate Epoetin Response Guideline 20: Causes for Inadequate Response to Epoetin Guideline 21: When to Obtain a Hematology Consultation Guideline 22: Epoetin-Resistant Patients VI. Role of Red Blood Cell Transfusions Guideline 23: Red Blood Cell Transfusions in Patients With Chronic Renal Failure VII. Possible Adverse Effects Related to Epoetin Therapy Guideline 24: Possible Adverse Effects Related to Epoetin Therapy: Hypertension Guideline 25: Possible Adverse Effects Related to Epoetin Therapy: Seizures Guideline 26: Possible Adverse Effects Related to Epoetin Therapy: Increased Clotting Tendency Guideline 27: Possible Adverse Effects Related to Epoetin Therapy: Hyperkalemia VIII. Endnotes IX. References X. Biographical Sketches of the NKF-KDOQI Anemia Work Group Members
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