New International Guideline Offers Direction for Care of Kidney Transplant Recipients
New York, NY (October 13, 2009) — For the first time in almost a decade, a new set of evidence-based recommendations has been released for the monitoring and treatment of kidney transplant recipients. The KDIGO Clinical Practice Guideline for the Care of the Kidney Transplant Recipients was developed by an international group of experts and an evidence review team who screened more than 15,000 clinical studies to create the guideline. Over 800 health care professionals from around the world were invited to critique and comment during the public review period. The guideline, which is the first to focus on long-term patient care, will be published this month as a supplement of the American Journal of Transplantation.
“The success of kidney transplantation in developed countries has created a challenge of providing long-term care to large numbers of transplant recipients. As the number of transplantations performed has grown, and kidney allograft survival has improved, the number of patients with functioning kidney allografts who need ongoing medical care has also grown,” said Bertram Kasiske, MD, Director of Nephrology at the University of Minnesota. and co-Chair of KDIGO, who also co-chaired the guideline workgroup.
The guideline encourages transplant worldwide by defining minimum standards, removing misconceptions and barriers, and calls for research, when evidence is poor. “The guideline focuses on patients who have a functioning kidney transplant. Although many aspects may be pertinent to recipients who have been transplanted with an organ other than, or in addition to, a kidney, they will not specifically target these populations,” said Dr. Kasiske.
The guideline covers four major areas, including:
Induction Therapy and Immunosuppression
Graft Monitoring and Infectious Diseases
Cardiovascular Disease Risk Management
Based upon the evidence reviewed for the guidelines, for the first time, the authors are recommending the use of induction therapy with a biologic agent as part of initial immunosuppression for all kidney transplant recipient.
Common complications, including hematologic and bone disorders, are also addressed. “As a global organization, it is KDIGO’s goal to help transplant-care providers throughout the world to apply our guidelines in their local setting for the benefits of patients,” said Kai-Uwe Eckardt, MD of the University Clinic Erlangen in Germany and Co-Chair of KDIGO.
The National Kidney Foundation Board-of Directors collaborated with KDIGO to provide the instrumental support to develop a global guideline for improving the outcomes for people receiving kidney transplants and KDIGO gratefully acknowledges the following consortium of sponsors that make our initiatives possible: Abbott, Amgen, Belo Foundation, Coca-Cola Company, Dole Food Company, Genzyme, Hofmann-LaRoche, JC Penney, NATCO–The Organization for Transplant Professionals, Novartis, Robert and Jane Cizik Foundation, Shire, Transwestern Commercial Services, and Wyeth.
KDIGO Guideline Development Process
KDIGO employs an evidence based approach that is modeled on the guideline development process used in the NKF-Kidney Disease Outcome Quality Initiative (KDOQI™) guidelines. It empowers an independent work group supported by evidence review experts to rigorously examine the published evidence and formulate 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 reviewed 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.