KDIGO Publishes First-Ever Guideline For Managing Glomerulonephritis
NEW YORK, NY (May 29, 2012) - Evidence-based treatment guided by renal biopsy diagnosis can alleviate symptoms and avoid progression to kidney failure in patients with glomerulonephritis, according to the first clinical practice guideline for glomerulonephritis. Published this month in Kidney International Supplements, the guideline was developed by an international group of experts, under the auspices of Kidney Disease: Improving Global Outcomes (KDIGO). KDIGO is managed by the National Kidney Foundation.
Glomerulonephritis is a group of disorders characterized by damage to the kidney's filtering unitswhich result in the appearance of protein and/or blood in the urine. This guideline recommends that patients in whom these abnormalities are detected should be referred to a nephrologist for evaluation and that a kidney biopsy may need tobe performed in orderto make a definitive diagnosis. According to the guideline, proteinuria is the most important parameter for predicting prognosis, relapse of disease and response to treatment, and persistent proteinuria is associated with a worse prognosis.
"Glomerulonephritis may not be curable in all cases, but with proper diagnosis and treatment, many patients can experience lasting remission and kidney function can be preserved," said Dr. David Wheeler, KDIGO co-chair. "Effective treatmentsfor glomerulonephritis include immunosuppressive agents which induce disease remission as well as medicines that reduce blood pressure and protein loss in the urine."
This guideline provides standard definitions for assessing response to therapy and identifying relapse of the major immune-mediated glomerular diseases on a global scale. It also offers guidance for individualization of therapy based on patient preferences and accounts for the variation in ability to access and cost of medications which are not uniform across the world.
The guideline emphasizes the need to understand the best evidence in the medical literaturein relationship to treatment effectiveness in controlling the disease process in the different types of glomerulonephritis, as well as identifying the weaknesses in the data and the need for more randomized controlled trials in these patient populations to establish the best therapies and to test alternative regimens.
KDIGO Guideline Development Process
KDIGO employs an evidence-based approach to guideline development. The working group was composed of many of the most experienced physician from across the world in the clinical management of glomerulonephritis supported by an evidence review team who rigorously examined the published dataand then worked together to formulated the practice guidelines. Before they are finalized, the draft guidelines undergo a two-stage review process: internal review by the KDIGO Board, followed by open peer review by interested organizations, agencies and individuals worldwide. Reviewer comments are carefully assessed by the work group, and incorporated as appropriate, before the guidelines are finalized and published.
KDIGO, a global non-profit foundation managed by the National Kidney Foundation, is dedicated to improving the care and outcomes of kidney disease patients worldwide through promoting coordination, collaboration, and integration of initiatives to develop and implement clinical practices guidelines. The clinical practice guideline for glomerulonephritis was published in Kidney International Supplements with financial support from the International Society of Nephrology.
The full glomerulonephritis guideline is available here