NKF-KDOQI Considers the Utility of Global Guidelines
Orlando, FL (April 16, 2010) — During a special session at the National Kidney Foundation's 2010 Spring Clinical Meetings, Kidney Disease Outcomes Quality Initiative (KDOQI) will present two commentaries regarding the application of global guidelines in the United States. The first commentary on CKD-MBD is currently available on American Journal of Kidney Diseases' (AJKD) website www.ajkd.org and will be published in the May 2010 issue while the second commentary on kidney transplant patients will be available this summer.
KDOQI US Commentary on the 2009 (KDIGO) Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) will be presented by Katrin Uhlig, MD of Tufts University School of Medicine, Director of Guideline Development at Tufts Center for Kidney Disease Guideline Development and Implementation and lead author of the commentary. She will contextualize the use of a global guideline in the US by summarizing the important differences between the prior KDOQI guidelines and the more current KDIGO guideline.
"For the most part, the KDIGO guideline is applicable to practice in the US," says Dr Uhlig. Key messages in the KDOQI commentary include:
Disorders of Mineral and bone metabolism (MBD) are highly prevalent in patients with CKD and indicate worse prognosis.
However, trials have not shown conclusive clinical benefit from treatments for CKD-MBD. Thus there is room for individualization of therapy. Bundled payment may impact drug selection going forward.
There is no high quality evidence to support specific treatment targets, but it is suggested to lower elevated phosphorus towards the normal range in dialysis patients and into the normal range in other CKD patients.
The suggested KDIGO PTH target range in dialysis patients is wider than that suggested by the prior KDOQI guideline.
Margaret Bia, MD of Yale University School of Medicine and primary author of KDOQI US Commentary on the 2009 (KDIGO) Clinical Practice Guideline for the Care of Kidney Transplant Recipients will lead discussions on four important messages:
The need for continued monitoring of kidney transplant recipient's kidney function and drug levels.
The use of kidney biopsy to determine causes of graft dysfunction even after the early post-transplant period.
Control of risk factors to prevent the high recurrence of cardiovascular disease.
Screening at various intervals for infections and cancers in this predisposed patient population.
Dr. Jeffrey Berns of the University of Pennsylvania School of Medicine, Vice Chair of KDOQI Guidelines and Commentaries, summarizes the goal of today's KDOQI session, "While it is important to expand the scope of practice guidelines and improve the care of patients with kidney disease worldwide, it is equally important to remember our patients and understand that implementation occurs on the local level."
All KDOQI commentaries are published in the American Journal of Kidney Diseases (AJKD) and available online at www.ajkd.org and www.kdoqi.org.
KDOQI Commentary on KDIGO Guidelines
KDOQI convened multidisciplinary groups to comment on the application and implementation of KDIGO's guidelines on CKD-MBD and Care of Kidney Transplant Recipients. Once the commentaries were drafted, the KDOQI Chair and Vice Chairs for Guidelines and Commentary, Research, Education, and Public Policy, as well as the NKF's Scientific Advisory Board reviewed the Commentary and their feedback was incorporated into the final articles to be published in the American Journal of Kidney Diseases (AJKD).
About the National Kidney Foundation
The National Kidney Foundation is dedicated to preventing and treating kidney and urinary tract diseases, improving the health and well being of individuals and families affected by these diseases, and increasing availability of all organs for transplantation.
To learn more about CKD risk factors, prevention and treatment, contact the National Kidney Foundation at www.kidney.org or (800)622-9010.
The National Kidney Foundation's Kidney Disease Outcomes Quality Initiative or (NKF KDOQI)™ provides evidence-based clinical practice guidelines developed by volunteer physicians and health care providers for all stages of chronic kidney disease and related complications, from diagnosis to monitoring and management. For more information visit www.kdoqi.org