Canadian Society of Nephrology Clinical Practice Guidelines

Published guidelines:

Name: Canadian Society of Nephrology Clinical Practice Guidelines

Single supplement covering 4 aspects

Coordinator: David Churchill (McMaster University, Hamilton)
Reference: JASN 1999 volume 10 (supplement 13).
Subtopics/Sections:

1) When to start dialysis - D Churchill
2) Haemodialysis delivery - M Goldstein
3) Vascular access - K Jindal
4) Peritoneal dialysis adequacy and nutrition - P Blake

Period covered by references: up to 1999
Search method: search by reference manager according to predefined keywords (entire work group, and use of DOQI references)
Website: http://csnscn.ca

Published guidelines:

Name: Elevated Creatinine Referral Guidelines

Coordinator: David Mendelssohn (University of Toronto)
Reference: Canadian Medical Association Journal, August 1999.
Subtopics:

1) Referral by general practitioners and subspecialists to nephrology
2) Work up and documentation of patients with kidney disease
3) Follow up of patients with kidney disease

Period covered by references: up to 1999
Search method: search by reference manager according to predefined keywords (entire work group)
Website: http://csnscn.ca

Published guidelines:

Name: Principles of End Stage Renal Disease Care

Coordinator: David Mendelssohn, on behalf of the Professional and Public Policy Committee of CSN
Reference: Annals of Royal College of Physicians and Surgeons 30; 271-273, 1997

Period covered by references: up to 1996
Search method: NA
Website: http://csnscn.ca

Published Guideline Update:

Name: Update of CSN Clinical Practice Guidelines

Single supplement covering 5 aspects

Coordinator: Bruce Culleton (University of Calgary), Chair of Guidelines Process
Workgroup Chair: K. Jindal
Reference: JASN 2006, 17: S1-S27
Subtopics/Sections:

1. Hemodialysis Adequacy in Adults
2. Management of Blood Pressure in Hemodialysis Patients
3. Mineral metabolism
4. Vascular Access
5. Frequent and Sustained Hemodialysis

Period covered by references: up to 1999
Search method: search by reference manager according to predefined keywords (entire work group, and use of DOQI references)
Website: http://csnscn.ca

Published Guideline Update:

Name: Care and Referral of Adult Patients with Reduced Kidney Function

Coordinator: Bruce Culleton (University of Calgary), Chair of Guidelines Process
Committee Chairs: A. Levin & D. Mendelssohn
Reference: Published online Sept. 2006 (CSNSCN.CA)

Period covered by references: up to 1999
Search method: search by reference manager according to predefined keywords (entire work group, and use of DOQI references)
Website: http://csnscn.ca

Planned Guideline Updates:

Coordinator: Bruce Culleton (University of Calgary), Chair of Guidelines Process
Start preparation: Varies by topic
Planned finalisation: Varies by topic
Subtopics:

 
1) Anemia (Chair, B. Manns).  Start October 2004, Final Draft to be presented June 2007.
2) Chronic Kidney Disease (non-dialysis). (Co-chairs, B. Hemmelgarn & A. Levin).

Start Spring 2005.  Final Draft to be presented June 2007

Implementation activities:  

• Publication of CSN Guidelines in JASN
• Educational talks by Nephrologists to GPs re : Referral and CKD
• Tools for estimation of calculated creatinine clearance and tracking ‘sheet’ for GP
• Addition of extra data collection re: Canadian Organ Replacement Registry (CORR) to address issues related to Anemia, vascular access, modality change and time of initiation

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(Caring For Australians, Renal Impairment) Guidelines - Australia/New Zealand:  Present Status

Published guidelines:

Name: CARI Part 1 – Dialysis Guidelines

Subtopic Coordinators:

1) P Snelling (Australia), J Collins (New Zealand);
2) D Francis, A Irish (Australia);
3) C Pollock, C Hawley (Australia);
4) P Kerr, D Johnson (Australia).

Reference: The CARI Guidelines, Editors: J Knight and D Vimalachandra, Sydney, Excerpta Medica Communications: March 2000.
Subtopics:

1) Acceptance onto dialysis;
2) Vascular access;
3) Biochemical and haematological targets;
4) Dialysis adequacy.

Period covered by references: up to 2000.
Search method: Individual guidelines searches conducted on Medline based on advice from Excerpta Medica Communications.
Website: www.cari.org.au

Planned guidelines:

Name: CARI Part 2 – Early Renal Impairment Guidelines

Subtopic Coordinators:

1) D Harris (Australia);
2) C Pollock (Australia);
3) R Walker (New Zealand);
4) G Elder (Australia)

Start Preparation: 2001
Planned finalisation: June 2005
Subtopics:

1) Prevention of progression of renal disease;
2) Nutrition and growth in kidney disease;
3) Cardiovascular risk factors;
4) Bone disease, calcium, phosphate and parathyroid hormone.

Name: CARI Part 3 – Transplantation Guidelines

Subtopic Coordinators:

1) S Campbell (Australia);
2) D Verran (Australia);
3) J Eris, H Moody (Australia).

Start Preparation: 2000
Planned finalisation: August 2005
Subtopics:

1) Recipient suitability;
2) Deceased organ donor suitability;
3) Living renal donors

Name: CARI Part 4 – Proteinuria, Peritonitis and CMV Infection Guidelines

Subtopic Coordinators:

1) N Isbel (Australia);
2) H Pilmore (New Zealand);
3) K Bannister (Australia)

Start Preparation: 2002
Planned finalisation: October 2004
Subtopics:

1) Urine protein as diagnostic test;
2) CMV disease and renal transplant;
3) Evidence for peritonitis treatment and prophylaxis

Name: CARI Part 5 – Kidney Stones/Calcineurin Inhibitors in Renal Transplantation

Subtopic Coordinators:

1) G Becker (Australia);
2) P Trevillian (Australia);

Start Preparation: December 2003
Planned finalisation: December 2005
Subtopics:

1) Kidney Stones;
2) Calcineurin Inhibitors in Renal Transplatation;

Implementation:

Electronic publication on CARI Website: guidelines are available at: www.cari.org.au

Distribution of printed guidelines to all renal units in Australia: March 2000, June/July 2004

Presentation at national meetings: eg Dialysis Nephrology Transplantation (DNT) Workshop, South Australia (March 2003).

Publication of Part 4 Proteinuria, Peritonitis and CMV Infection guidelines: Supplement in the October 2004 edition of ‘Nephrology’ (Published on behalf of the Asian Pacific Society of Nephrology).
 

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KDOQI (Kidney Disease Outcomes Quality Initiative) Guidelines – United States: Present Status

Published guidelines:

Name: KDOQI Clinical Practice Guidelines for Managing Dyslipidemias in Chronic Kidney Disease

Subtopic Coordinators:

J Beto (US);
B Chavers (US);
F G Cosio (US);
R Grimm (US);
B Kasiske (US);
A Levin (Canada);
B Masri (US);
R Parekh (US);
C Wanner (Germany);
D Wheeler (UK);
P Wilson (US)

Reference: National Kidney Foundation. K/DOQI Clinical Practice Guidelines for Managing Dyslipidemias in Chronic Kidney Disease. American Journal of Kidney Diseases, Vol 41, No 4, Suppl 3 (April), 2003: pp S1-S92.
Subtopics:

1) Abstract;
2) Introduction;
3) Assessment of Dyslipidemias (Guideline 1-3);
4) Treating Dyslipidemias (Guideline 4-5);
5) Research Recommendations.

Period covered by references: 1980 – May 2001
Search method: Studies for the literature review were identified primarily through Medline searches of published studies in the English language and supplemented by relevant articles known to the domain experts and reviewers. The searches identified clinical studies published from 1980 through May 2001. Studies prior to 1980 were disregarded because the Work Group concluded that treatment modalities and methods to measure dyslipidemias have changed too much to reasonably conclude that evidence from studies prior to 1980 could be applicable today.
Website: http://www.kidney.org/professionals/kdoqi/guidelines.cfm

Name: KDOQI Clinical Practice Guidelines for Chronic Kidney Disease: Evaluation, Classification and Stratification

Subtopic Coordinators:
ADULT WORK GROUP MEMBERS:

K Bolton (US);
J Coresh (US);
B Culleton (Canada);
K S Harvey (US);
T A Ikizler (US);
C A Johnson (US);
A Kausz (US);
P L Kimmel (US);
J Kusek (US);
A S Levey (US);
A Levin (Canada);
K L Minaker (US);
R Nelson (US);
H Rennke (US);
M Steffes (US);
B Witten (US).

PEDIATRIC WORK GROUP MEMBERS:

S Furth (US);
R J Hogg (US);
K V Lemley (US);
R J Portman (US);
G Schwartz (US).

Reference: National Kidney Foundation: K/DOQI Clinical Practice Guidelines for Chronic Kidney Disease: Evaluation, Classification and Stratification. American Journal of Kidney Diseases, Vol 39, No 2, Suppl 1 (February), 2002: pp S1-S266.
Subtopics:

1) Executive Summary;
2) Background;
3) Chronic Kidney Disease as a Public Health Problem;
4) Definition and Classification of Stages of Chronic Kidney Disease (Guideline 1-3);
5) Evaluation of Laboratory Measurements for Clinical Assessment of Kidney Disease (Guideline 4-6);
6) Association of Level of GFR With Complications in Adults (Guideline 7-12);
7) Stratification of Risk for Progression of Kidney Disease and Development of Cardiovascular Disease (Guideline 13-15);
8) Recommendations for Clinical Performance Measures;
9) Approach to Chronic Kidney Disease Using These Guidelines.

Period covered by references: 1966 – June 2000
Search method: Studies for the literature review were identified primarily through Medline searches of published studies in the English language and supplemented by relevant articles known to the domain experts and reviewers. The searches identified clinical studies published from 1966 through June 2000.
Website: http://www.kidney.org/professionals/kdoqi/guidelines.cfm

Name: NKF-KDOQI Clinical Practice Guidelines For Nutrition of Chronic Renal Failure

Subtopic Coordinators:
ADULT WORK GROUP MEMBERS:

S Ahmad (US);
J D Burrowes (US);
G M Chertow (US);
D B Cockram (US);
C J Foulks (US);
D Fouque (France);
J D Kopple (US);
B Maroni (US);
L W Moore (US);
M Wolfson (US).

PEDIATRIC WORK GROUP MEMBERS:

J C M Chan (US);
R N Fine (US);
C B Langman (US);
B Morgenstern (US);
P Nelson (US);
I B Salusky (US);
B A Warady (US).

Reference: National Kidney Foundation. K/DOQI Clinical Practice Guidelines For Nutrition of Chronic Renal Failure. American Journal of Kidney Diseases, Vol 37, No 1, Suppl 2 (January), 2001: pp S66-70.
Subtopics:

1) Introduction;
2) Guideline Development Methodology;
3) Clinical Practice Guidelines;
4) Maintenance Dialysis (Adult Guideline 1-12);
5) Management of Acid-Base Status (Adult Guideline 13-14);
6) Management of Protein and Energy Intake (Adult Guideline 15-22);
7) Advance Chronic Renal Failure Without Dialysis (Adult Guideline 23-27);
8) Guidelines (Pediatric Guideline 1-10).

Period covered by references: Up to 2000
Search method: Studies for the literature review were identified primarily through Medline and Embase searches of published studies in the English language. The search was supplemented by relevant articles known to the domain experts and reviewers.

Website: http://www.kidney.org/professionals/kdoqi/guidelines.cfm

Name: NKF-KDOQI Clinical Practice Guidelines For Hemodialysis Adequacy: Update 2000

Subtopic Coordinators:

S Alexander (US);
D Cohen (US);
W Harmon (US);
T Ing (US);
J Kari (US);
M Keen (US);
K King (US);
J Letteri (US);
P Lundin (US);
T Messana (US);
J Nardini (US);
K Norris (US);
W Owen (US);
G Politoski (US);
J Roberts (US).

Reference: National Kidney Foundation. K/DOQI Clinical Practice Guidelines For Hemodialysis Adequacy, 2000. American Journal of Kidney Diseases, Vol 37, No 1, Suppl 1 (January), 2001: pp S7-S62.
Subtopics:

1) Introduction;
2) Measurement of Hemodialysis Adequacy (Guideline 1-3);
3) Hemodialysis Dose (Guideline 4-6);
4) Blood Urea Nitrogen (BUN) Sampling (Guideline 7-9);
5) Hemodialyzer Reprocessing and Reuse (Guideline 10-13);
6) Hemodialysis Dose Troubleshooting (Guideline 14);
7) Maximizing Patient Adherence to the Hemodialysis Prescription (Guideline 15-16).

Period covered by references: 1997 - 2000.
Search method: The update process focused on articles published since 1997 and applicable to strengthening the rationale for a guideline, strengthening the evidence base or requiring a change in a guideline statement (a total of 85 articles were reviewed for the HD, PD, VA and Anemia Updates).
Website: http://www.kidney.org/professionals/kdoqi/guidelines.cfm

Name: NKF-KDOQI Clinical Practice Guidelines For Peritoneal Dialysis Adequacy: Update 2000

Subtopic Coordinators:

P Blake (Canada);
J Burkart (US);
D Chatoth (US);
D Churchill (Canada);
C Firanek (US);
D Geary (Canada);
T Golper (US);
F Gotch (US);
A Kliger (US);
S Korbet (US);
L Moore (US);
K Nolph (US);
N Powe (US);
H Singh (US);
B Teehan (US);
A Tzamaloukas (US);
B Warady (US).

Reference: National Kidney Foundation. K/DOQI Clinical Practice Guidelines For Peritoneal Dialysis Adequacy, 2000. American Journal of Kidney Diseases, Vol 37, No 1, Suppl 1 (January), 2001: pp S65-S134.
Subtopics:

1) Introduction;
2) Initiation of Dialysis (Guideline 1-2);
3) Measures of Peritoneal Dialysis Dose (Guideline 3-7);
4) Measurement of Peritoneal Dialysis Dose (Guideline 8-11);
5) Assessment of Nutritional Status Specifically as It Relates to Peritoneal Dialysis (Guideline 12-14);
6) Adequate Dose of Peritoneal Dialysis (Guideline 15-18);
7) Strategies for Increasing the Likelihood of Achieving the Prescribed Dose of Peritoneal Dialysis (Guideline 19-20);
8) Clinical Outcome Goals for Adequate Peritoneal Dialysis (Guideline 21-28);
9) Suitable Patients for Peritoneal Dialysis (Guideline 29-32).

Period covered by references: 1997 - 2000
Search method: The update process focused on articles published since 1997 and applicable to strengthening the rationale for a guideline, strengthening the evidence base or requiring a change in a guideline statement (a total of 85 articles were reviewed for the HD, PD, VA and Anemia Updates).
Website: http://www.kidney.org/professionals/kdoqi/guidelines.cfm

Name: NKF-KDOQI Clinical Practice Guidelines For Vascular Access:  Update 2000

Subtopic Coordinators:

A Besarab (US);
G Beathard (US);
D Brouwer (US);
E Etheredge (US);
M Hartigan (US);
M Levine (US);
R McCann (US);
S Schwab (US);
R Sherman (US);
S Trerotola (US).

Reference: National Kidney Foundation. K/DOQI Clinical Practice Guidelines For Vascular Access, 2000. American Journal of Kidney Diseases, Vol 37, No 1, Suppl 1 (January), 2001: pp S137-180.
Subtopics:

1) Introduction;
2) Patient Evaluation Prior to Access Placement (Guideline 1-9);
3) Monitoring, Surveillance, and Diagnostic Testing (Guideline 10-12);
4) Prevention of Complications: Infection (Guideline 13-15);
5) Management of Complications: When to Intervene (Guideline 16-18);
6) Management of Complications: Optimal Approaches for Treating Complications (Guideline 19-28);
7) Potential Quality of Care Standards (Guideline 29-38).

Period covered by references: 1997 - 2000
Search method: The update process focused on articles published since 1997 and applicable to strengthening the rationale for a guideline, strengthening the evidence base or requiring a change in a guideline statement (a total of 85 articles were reviewed for the HD, PD, VA and Anemia Updates).
Website: http://www.kidney.org/professionals/kdoqi/guidelines.cfm

Name: NKF-KDOQI Clinical Practice Guidelines For Anemia of Chronic Kidney Disease: Update 2000

Subtopic Coordinators:

J Adamson (US);
J Berns (US);
G Biddle (US);
T Comstock (US);
P DeOreo (US);
J Eschbach (US);
K Jabs (US);
M Lazarus (US);
A Nissenson (US);
J Stivelman (US);
D Van Wyck (US);
J Wish (US).

Reference: National Kidney Foundation. K/DOQI Clinical Practice Guidelines For Anemia of Chronic Kidney Disease, 2000. American Journal of Kidney Diseases, Vol 37, No 1, Suppl 1 (January), 2001: pp S182-S236.
Subtopics:

1) Introduction;
2) Anemia Work-Up (Guideline 1-3);
3) Target Hemoglobin/Hematocrit (Guideline 4);
4) Iron Support (Guideline 5-10);
5) Administration of Epoetin (Guideline 11-19);
6) Inadequate Epoetin Response (Guideline 20-22);
7) Role of Red Blood Cell Transfusions (Guideline 23);
8) Possible Adverse Effects Related to Epoetin Therapy (Guideline 24-27).

Period covered by references: 1997 - 2000
Search method: The update process focused on articles published since 1997 and applicable to strengthening the rationale for a guideline, strengthening the evidence base or requiring a change in a guideline statement (a total of 85 articles were reviewed for the HD, PD, VA and Anemia Updates).
Website: http://www.kidney.org/professionals/kdoqi/guidelines.cfm

Name: KDOQI Clinical Practice Guidelines for Bone Metabolism and Disease in Chronic Kidney Disease

Subtopic Coordinators:

G M Chertow (US);
J Coburn (US);
K Hruska (US);
C Langman (US);
H Malluche (US);
K Martin (US);
S G Massry (US);
L M McCann (US);
J T McCarthy (US);
S Moe (US),
I B Salusky (US);
D J Sherrard (US);
M Smogorzewski (US);
K Bolton (US).

Start Preparation: January 2000
Finalization: October 2003
Subtopics:

1) Evaluation of Calcium and Phosphorus Metabolism (Guideline 1);
2) Assessment of Bone Disease Associated with CKD (Guideline 2);
3) Evaluation of Serum Phosphorus Levels (Guideline 3);
4) Restriction of Dietary Phosphorus in Patients with CKD (Guideline 4);
5) Use of Phosphate Binders in CKD (Guideline 5);
6) Serum Calcium and Calcium-Phosphorus Product (Guideline 6);
7) Prevention and Treatment of Vitamin D Insufficiency and Vitamin D Deficiency in CKD Patients (Guideline 7; Algorithm 1);
8) Vitamin D Therapy in CKD Patients (Guideline 8);
9) Active Vitamin D Therapy in Patients with Stages 3 and 4 CKD (Guideline 8A ; Algorithm 2);
10) Vitamin D Therapy in Patients on Dialysis (Guideline 8B; CKD Stage 5);
11) Dialysate Calcium Concentrations (Guideline 9);
12) 2-Microglobulin Amyloidosis (Guideline 10);
13) Aluminum Overload and Toxicity in CKD (Guideline 11);
14) Treatment of Aluminum Toxicity (Guideline 12);
15) Treatment of Bone Disease in CKD (Guideline 13);
16) Hyperparathyroid (High-Turnover) and Mixed (High-Turnover with Mineralization Defect) Bone Disease (Guideline 13A);
17) Osteomalacia (Guideline 13B);
18) Adynamic Bone Disease (Guideline 13C);
19) Parathyroidectomy in Patients with CKD (Guideline 14);
20) Metabolic Acidosis (Guideline 15); 21) Bone Disease in the Kidney Transplant Recipient (Guideline 16).

Period covered by references: 1966 – January 2001
Search Method: Studies for the literature review were identified primarily through Medline, Embase, PsychLit, Cochrane Library and CINAHL, and supplemented by relevant articles known to the domain experts and reviewers. The searches identified clinical studies published from 1966 through January 2001.

Name: KDOQI Clinical Practice Guidelines on Blood Pressure Management and Use of Antihypertensive Agents in Chronic Kidney Disease

Subtopic Coordinators:

L Agodoa (US);
S Anderson (US);
S P Andreoli (US);
G Bailie (US);
G L Bakris (US);
M B Callahan (US);
J Cutler (US);
J Greene (US);
T Hostetter (US);
C A Johnson (US);
J P Lash (US);
A Levey (US);
P McCullough (US);
E R Miller (US);
J Nally (US);
J Pirsch (US);
R J Portman (US);
M V Rocco (US);
M A Sevick (US);
D E Wesson (US).

Start Preparation: July 2001
Finalization: February 2004
Subtopics:

1) Goals of Antihypertensive Therapy in Chronic Kidney Disease (Guideline 1);
2) Evaluation;
3) Measurement of Blood Pressure in Adults;
4) Evaluation for Renal Artery Disease;
5) Education on Self-Management Behavior;
6) Dietary and Other Therapeutic Lifestyle Changes;
7) Pharmacologic Therapy: Use of Antihypertensive Agents in CKD;
8) Pharmacologic Therapy: Diabetic Kidney Disease;
9) Pharmacologic Therapy: Non-Diabetic Kidney Disease;
10) Pharmacologic Therapy: Kidney Disease in the Transplant Recipient;
11) Use of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in Chronic Kidney Disease;
12) Use of Diuretics in Chronic Kidney Disease;
13) Special Considerations in Children.

Period covered by references: 1966 – July 2002
Search method: Studies for the literature review were identified primarily through Medline searches of published studies in the English language and supplemented by relevant articles known to the domain experts and reviewers. The searches identified clinical studies published from 1966 through July 2002.

Name: KDOQI Clinical Practice Guidelines Cardiovascular Disease in Dialysis Patients

Subtopic Coordinators:

S Beddhu (US);
V Campese (US);
A K Cheung (US);
D Churchill (Canada);
D J Goldstein (US);
W L Henrich (US);
C Herzog (US);
K King (US);
F Kronenberg (Austria);
B S Miholics (US);
P L Painter (US);
M Roberts (US);
C Stehman-Breen (US);
P Stenvinkel (Sweden);
R Wali (US);
M Weiss (US).

Start Preparation: November 2001
Planned finalization: March 2005
Subtopics:

1) Introduction (Guideline 1);
2) Evaluation and Management of End Organ Diseases (Guideline 2-10);
3) Evaluation and Management of Risk Factors (Guideline 11-17);
4) Other Issues Related to the Hemodialysis Procedure (Guideline 18).

Period covered by references: 1966 – April 2003.
Search method: Studies for the literature review were identified primarily through Medline searches of published studies in the English language and supplemented by relevant articles known to the domain experts and reviewers. The searches identified clinical studies published from 1966 – April 2003.

Name: KDOQI Clinical Practice Guidelines for Diabetes in Chronic Kidney Disease

Subtopic Coordinators:

P Aschner (Colombia);
G L Bakris (US);
R Bilous (UK);
M M Chapman (US);
D J Goldstein (US);
S M Mauer (US);
M Molitch (US);
A Narva (US);
R Nelson (US);
M Pfeffer (US);
M A Sevick (US);
M Shlipak (US);
K Tuttle (US);
C Wanner (Germany);
J A Cutler (US);
T Hostetter (US).

Start Preparation: September 4, 2003
Planned finalization:  January 2005

1) Diagnosis,
2) Staging,
3) Blood Pressure,
4) Lipids,
5) Glycemia,
6) Urinary Albumin Excretion,
7) Nutrition,
8) Special Populations,
9) Behavioral Management,
10) Novel Treatments

Search Method: Studies for the literature review were identified primarily through Medline searches of published studies in the English Language and supplemented by relevant articles known to the domain experts and reviewers.

Name: KDOQI Clinical Practice Guidelines for Hemodialysis Adequacy {update}

Subtopic Coordinators:

J T Daugirdas (US)
T A Depner (US),
S Goldstein (US),
T Ing (US),
M L Keen (US),
V Kumar (US),
K Meyer (US),
K Norris (US).

Start Preparation: June 2004
Planned finalization: October 2005
Subtopics:

1) Initiation of hemodialysis,
2) Measurement of hemodialysis adequacy,
3) Prescription of adequate hemodialysis,
4) Non-dose-related components of dialysis adequacy,
5) Pediatric Hemodialysis

Period covered by references: January 2000 – July 2004.
Search method: Studies for the literature review were identified primarily through Medline searches of published studies in the English language and supplemented by relevant articles known to the domain experts and reviewers. The searches identified clinical studies published from January 2000 – July 2004.

Name: KDOQI Clinical Practice Guidelines for Peritoneal Dialysis Adequacy {update}

Subtopic Coordinators:

J Bargman (Canada),
P Blake (Canada),
J M Burkart (US),
F O Finkelstein (US),
T A Golper (US),
A Graham (US),
B Piraino (US),
S Stark (US),
B Warady (US),
R A Wolfe (US).
 

Start Preparation: June 2004
Planned finalization: October 2005
Subtopics:

1) Initiation of peritoneal dialysis,
2) Measurement of peritoneal membrane function, PD adequacy and ultrafiltration,
3) Adequate dose of peritoneal dialysis,
4) Writing the PD prescription,
5) Preservation of residual renal function,
6) Management of PD failure,
7) PD in pediatric patients

Period covered by references: January 2000 – July 2004.
Search method: Studies for the literature review were identified primarily through Medline searches of published studies in the English language and supplemented by relevant articles known to the domain experts and reviewers. The searches identified clinical studies published from January 2000 – July 2004.

Name: KDOQI Clinical Practice Guidelines for Vascular Access {update}

Subtopic Coordinators:

A Besarab (US),
D Brouwer (US),
T Bunchman (US),
L Dinwiddie (US),
S Goldstein (US),
M Henry (US),
K Konner (Germany),
A Lumsden (US),
T Vesely (US),
J Work (US).

Start Preparation: June 2004
Planned finalization: October 2005
Subtopics:

1) Patient preparation for permanent HD access,
2) Selection and placement of permanent HD access,
3) Detection of access dysfunction - Monitoring, surveillance, and diagnostic testing,
4) Prevention and treatment of AV fistula complications,
5) Prevention and treatment of AV graft complications,
6) Prevention and treatment of catheters and port complications

Period covered by references: January 2000 – July 2004.
Search method: Studies for the literature review were identified primarily through Medline searches of published studies in the English language and supplemented by relevant articles known to the domain experts and reviewers. The searches identified clinical studies published from January 2000 – July 2004.

Implementation:
Electronic publications: Guidelines are available at www.kidney.org and www.ajkd.org
Printed resources:

Chronic Kidney Disease: Evaluation, Classification and Stratification

Presentation at national meetings: American Academy of Family Physicians / American College of Physicians / American Society of Hypertension / American Society of Nephrology / Dialysis Conference (formerly PD) / ERA-EDTA World Congress of Nephrology / International Conference on Dialysis / NKF Clinical Meetings / Renal Physicians Association (RPA)

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DOQI (Dialysis Outcomes Quality Initiative) Guidelines – United States: Present Status

Published guidelines:

Name: NKF-DOQI Clinical Practice Guidelines For Hemodialysis Adequacy

Subtopic Coordinators:

S Alexander (US);
D Cohen (US);
W Harmon (US);
T Ing (US);
J Kari (US);
M Keen (US);
K King (US);
J Letteri (US);
P Lundin (US);
T Messana (US);
J Nardini (US);
K Norris (US);
W Owen (US);
G Politoski (US);
J Roberts (US).

Reference: National Kidney Foundation. DOQI Clinical Practice Guidelines For Hemodialysis Adequacy. Am J Kidney Dis 30:S15-S64, 1997 (suppl 2)
Subtopics:

1) Introduction;
2) Measurement of Hemodialysis (Guideline 1-3);
3) Hemodialysis Dose (Guideline 3-6);
4) Blood Urea Nitrogen (BUN) Sampling (Guideline 7-9);
5) Hemodialyzer Reprocessing and Reuse (Guideline 10-13);
6) Hemodialysis Dose Troubleshooting (Guideline 14);
7) Maximizing Patient Compliance to the Hemodialysis Prescription (Guideline 15-16).

Period covered by references: Up to 1997.
Search method: Studies for the literature review were identified primarily through Medline, Embase, SciSearch and Biosis Previews searches of published studies in the English language. The search was supplemented by relevant articles known to the domain experts and reviewers.
Website: http://www.kidney.org/professionals/kdoqi/guidelines.cfm

Name: NKF-DOQI Clinical Practice Guidelines For Peritoneal Dialysis Adequacy.

Subtopic Coordinators:

D Churchill (Canada);
J Burkart (US);
C Firanek (US);
D Geary (Canada);
T Golper (US);
F Gotch (US);
L Moore (US);
K Nolph (US);
N Powe (US);
H Singh (US);
B Teehan (US);
A Tzamaloukas (US);
B Warady (US).

Reference: National Kidney Foundation. DOQI Clinical Practice Guidelines For Peritoneal Dialysis Adequacy. Am J Kidney Dis 30:S67-S134, 1997 (suppl 2)
Subtopics:

1) Introduction;
2) Initiation of Dialysis (Guideline 1-2);
3) Measures of Peritoneal Dialysis Dose (Guideline 3-7);
4) Measurement of Peritoneal Dialysis Dose (Guideline 8-11);
5) Assessment of Nutritional Status Specifically as it Relates to Peritoneal Dialysis (Guideline 12-14);
6) Adequate Dose of Peritoneal Dialysis (Guideline 15-18);
7) Strategies for Increasing the Likelihood of Achieving the Prescribed Dose of Peritoneal Dialysis (Guideline 19-20);
8) Clinical Outcome Goals for Adequate Peritoneal Dialysis (Guideline 21-28);
9) Suitable Patients for Peritoneal Dialysis (Guideline 29-32).

Period covered by references: Up to 1997
Search method: Studies for the literature review were identified primarily through Medline, Embase, SciSearch and Biosis Previews searches of published studies in the English language. The search was supplemented by relevant articles known to the domain experts and reviewers.
Website: http://www.kidney.org/professionals/kdoqi/guidelines.cfm

Name: NKF-DOQI Clinical Practice Guidelines For Vascular Access

Subtopic Coordinators:

A Besarab (US);
G Beathard (US);
D Brouwer (US);
E Etheredge (US);
M Hartigan (US);
M Levine (US);
R McCann (US);
S Schwab (US);
R Sherman (US);
S Trerotola (US).

Reference: National Kidney Foundation. DOQI Clinical Practice Guidelines For Vascular Access. Am J Kidney Dis 30:S150-S190, 1997 (suppl 3)
Subtopics:

1) Introduction;
2) Patient Evaluation Prior to Access Placement (Guideline 1-9);
3) Monitoring and Maintenance (Guideline 10-12);
4) Prevention of Complications: Infection (Guideline 13-15);
5) Management of Complications: When to Intervene (Guideline 16-18);
6) Management of Complications: Optimal Approaches for Treating Complications (Guideline 19-28);
7) Potential Quality of Care Standards (Guideline 29-38).

Period covered by references: Up to 1997
Search method: Studies for the literature review were identified primarily through Medline, Embase, SciSearch and Biosis Previews searches of published studies in the English language. The search was supplemented by relevant articles known to the domain experts and reviewers.
Website: http://www.kidney.org/professionals/kdoqi/guidelines.cfm

Name: NKF-DOQI Clinical Practice Guidelines for the Treatment of Anemia of Chronic Renal Failure

Subtopic Coordinators:

J Adamson (US);
J Berns (US);
G Biddle (US);
T Comstock (US);
P DeOreo (US);
J Eschbach (US);
K Jabs (US);
M Lazarus (US);
A Nissenson (US);
J Stivelman (US);
D Van Wyck (US);
J Wish (US).

Reference: National Kidney Foundation. DOQI Clinical Practice Guidelines For Anemia of Chronic Kidney Disease. Am J Kidney Dis 30:S192-S238, 1997 (suppl 3)
Subtopics:

1) Introduction;
2) Anemia Work-Up (Guideline 1-3);
3) Target Hematocrit/Hemoglobin (Guideline 4);
4) Iron Support (Guideline 5-10);
5) Administration of Epoetin (Guideline 11-19);
6) Inadequate Epoetin Response (Guideline 20-22);
7) Role of Red Blood Cell Transfusions (Guideline 23);
8) Possible Adverse Effects Related to Epoetin Therapy (Guideline 24-28).

Period covered by references: Up to 1997
Search method: Studies for the literature review were identified primarily through Medline, Embase, SciSearch and Biosis Previews searches of published studies in the English language. The search was supplemented by relevant articles known to the domain experts and reviewers.
Website: http://www.kidney.org/professionals/kdoqi/guidelines.cfm

DOQI (DISEASE OUTCOMES QUALITY INITIATIVE) GUIDELINES – UNITED STATES: PRESENT STATUS

Implementation

Electronic publications: Guidelines are available at www.kidney.org and www.ajkd.org
Distributed to: U.S. dialysis units
Printed resources: American Journal of Kidney Diseases (AJKD) Supplements / Caddy / CD Rom
Presentation at national meetings: American Society of Nephrology / Dialysis Conference / ERA-EDTA World Congress of Nephrology / NKF Clinical Meetings

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RPA (RENAL PHYSICIANS ASSOCIATION) GUIDELINES – UNITED STATES: PRESENT STATUS

Published guidelines:

Name: Appropriate Patient Preparation for Renal Replacement Therapy (RPA Clinical Practice Guideline # 3)

Subtopic Coordinators:

RENAL PHYSICIANS ASSOCIATION:
W Kline Bolton;
W F Owen, Jr.;
D Singer.

CONTENT EXPERTS:
J Coburn;
W Haley;
A Kausz;
A Levin;
W Mitch;
P Painter;
M Rocco.

ASSOCIATION REPRESENTATIVES:
C Atkins;
S Clark;
P Eggers;
L Fedje;
R Goldman;
J Greer;
C Thomas Hawkins;
R Lafayette;
V Norwood;
E Z Oddone;
P M Palevsky;
S Peckens;
V Rao;
J White.

Reference: Renal Physicians Association Working Committee on Clinical Practice Guidelines. Clinical Practice Guideline on Appropriate Patient Preparation for Renal Replacement Therapy. Clinical Practice Guideline, Number 3. Washington, DC. October 2002.
Subtopics:

1) Executive Summary;
2) Introduction;
3) Anemia Guidelines for Patients With Advanced CKD;
4) Bone Disease Guidelines for Patients With Advanced CKD;
5) Hypertension Guidelines for Patients With Advanced CKD;
6) Nutrition Guidelines for Patients With Advanced CKD;
7) Dyslipidemia Guidelines for Patients With Advanced CKD;
8) Counseling and Rehabilitation Guidelines for Patients With Advanced CKD;
9) Timing of Initiation for RRT for Patients With Advanced CKD;
10) Implementation Tools

Period covered by references: January 1988 – February 2002
Search method: Studies for the literature review were identified primarily through MEDLINE. The comprehensive literature search covered all the available published peer-reviewed literature in English from January 1988 to December 2001. Additional ad hoc searches included articles published through February 2002.
Website: http://www.renalmd.org

Name: Clinical Practice Guideline on Shared Decision-Making in the Appropriate Initiation of and Withdrawal from Dialysis (RPA Clinical Practice Guideline # 2)

Subtopic Coordinators:

R Albert;
E Brewer;
H Danko;
J H Galla;
R M Hendrickson;
A R Jonsen;
J Kari;
B Kasiske;
K King;
J Kitsen;
A H Moss;
J M Newmann;
W F Owen, Jr.;
C A Price;
R Rettig;
D Singer.

Reference: Renal Physicians Association Working Committee on Clinical Practice Guidelines. Clinical Practice Guideline on Shared Decision-Making in the Appropriate Initiation of and Withdrawal from Dialysis. Clinical Practice Guideline, Number 2. Washington, DC. 1999.
Subtopics:

1) Executive Summary;
2) Shared Decision-Making;
3) Informed Consent or Refusal;
4) Estimating Prognosis;
5) Conflict Resolution;
6) Advance Directives;
7) Withholding or Withdrawing Dialysis;
8) Special Patient Groups;
9) Time-Limited Trials;
10) Palliative Care

Period covered by references: 1985 - 1998
Search method: Pertinent English language literature published from 1985 to December 1998 was identified from electronic databases (MEDLINE, CINAHL, HealthStar, PsycINFO EMBASE), references from articles, experts, and hand searches of eight medical and nephrology journals of issues covering the last six months of 1998. Research evidence based on data collected before 1985 was not sought because marked technological advances in dialysis delivery had occurred since that time.
Website: http://www.renalmd.org

Name: Clinical Practice Guideline on Adequacy of Hemodialysis (RPA Clinical Practice Guideline # 1)

Subtopic Coordinators:

B Bednar;
W M Bennett;
J P Bosch;
J Crouch (K King);
R L Ellis;
D L Latos;
J M Letteri;
J M Newmann;
J T Philbrick;
J L Roberts;
D A VanValkenburgh.
NON-VOTING:
L H Diamond;
J C Hornberger;
M M Kolb;
N W Levin;
M A Marshall;
E P Paganini.

Reference: Renal Physicians Association Working Committee on Clinical Practice Guidelines. Clinical Practice Guideline on Adequacy of Hemodialysis. Clinical Practice Guideline, Number 1. Washington, DC. December 1993
Subtopics:

1) Executive Summary;
2) Clinical Practice Guideline on Adequacy of Hemodialysis;
3) Methods for Measuring the Delivered Dose of Dialysis;
4) The Process of Guideline Development;
5) Background of the Problem – End-Stage Renal Disease;
6) Second Generation Logarithmic Estimates of Single-Pool Variable Volume Kt/V; An Analysis of Error (John T. Daugirdas, MD);
7) Synthesis of the Existing Literature;
8) Results of the Independent Commissioned Study; Quality-Adjusted Life Expectancy and Cost-Effectiveness (John C. Hornberger, MD)

Period covered by references: Up to 1993
Search method: Studies for the literature review were identified primarily through MEDLINE, peer review journal articles, and relevant abstracts presented and published at the meetings of the American Society of Nephrology from 1980 - 1992.
Website: http://www.renalmd.org

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European Best Practice Guidelines: Present Status

EUROPEAN BEST PRACTICE GUIDELINES FOR HAEMODIALYSIS

Published guidelines:

Name: European Best Practice Guidelines for Haemodialysis Part 1

Coordinator: M Kessler (France)
Reference: Nephrol Dial Transplant, 17 (Suppl 7), 1-111, 2002
Subtopics:

1) Measurement of renal function, when to refer and when to start dialysis;
2) Haemodialysis adequacy;
3) Biocompatibility;
4) Dialysis fluid purity;
5) Chronic intermittent haemodialysis and prevention of clotting in the extracorporeal system;
6) Haemodialysis-associated infection;
7) Vascular disease and risk factors.

Period covered by references: up to 2001
Search method: search by reference manager 9 according to predefined keywords (entire work group)
Website: http://ndt.oxfordjournals.org/content/vol17/suppl_7/index.dtl

Planned guidelines:

Name: European Best Practice Guidelines for Haemodialysis Part 2

Coordinator: R Vanholder (Belgium)
Start preparation: April 2003
Planned finalisation: January 2005
Subtopics:

1) Intradialytic haemodynamic instability;
2) Malnutrition and acidosis;
3) Haemodialysis strategies;
4) Vascular access

Further guidelines or updates:
Not yet planned

Implementation:
Presentation of EBPG-HD at International meetings: amongst others Danish Society of Nephrology (May 2002), ERA-EDTA meeting Copenhagen (June 2002), Meeting Russian, White Russian and Ukrainian Nephrologists (May 2003), ERA-EDTA meeting Berlin (June 2003), EDTNA-meeting Birmingham (September 2003)
Distribution booklets with résumé guidelines: ERA-EDTA meetings Copenhagen and Berlin
Guideline quiz: e-journal of Nephrol Dial Transplant
Addition specific questions to the questionnaire of the ERA-registry CME-course on EBPG: planned for December 2004

EUROPEAN BEST PRACTICE GUIDELINES FOR ANAEMIA

Published guidelines:

Name: European Best Practice Guidelines for the Management of Anaemia

Coordinator: S Cameron (UK)
Reference: Nephrol Dial Transplant, 15 (Suppl 4), 1-76, 2000
Subtopics:

1) Evaluating anaemia and initiating treatment;
2) Target Haemoglobin;
3) Assessing and optimizing iron stores;
4) Anaemia management;
5) Inadequate response to erythropoietin;
6) Adverse effects.

Period covered by references: up to 2000
Search method: -
Website: Part 1: http://www.ndt-educational.org/images/EBPG Anemia Part 1.pdf
Part 2: http://www.ndt-educational.org/images/EBPG Anemia Part 2.pdf

Update:

Name: European Best Practice Guidelines for the Management of Anaemia (first update)

Coordinator: F Locatelli (Italy)
Start preparation: November 2002
Finalisation: December 2003
Subtopics:

1) Evaluating anaemia and initiating treatment;
2) Target Haemoglobin;
3) Assessing and optimizing iron stores;
4) Anaemia management;
5) Inadequate response to erythropoietin;
6) Adverse effects.

Implementation:
Presentation of EBPG-anaemia at International meetings: ERA-EDTA congress Lisbon 2004
Distribution booklets with résumé guidelines: -
Guideline quiz: e-journal of Nephrol Dial Transplant
Implementation control through specific registry: European Survey on Anaemia Management

EUROPEAN BEST PRACTICE GUIDELINES FOR TRANSPLANTATION

Published guidelines:

Name: European Best Practice Guidelines for Transplantation Part 1

Coordinator: F Berthoux (France)
Reference: Nephrol Dial Transplant, 15 (Suppl 7), 1-85, 2000
Subtopics:

1) Evaluation, selection and preparation of the potential transplant recipient;
2) Evaluation and selection of donors;
3) The transplant recipient from initial transplant hospitalization to 1 year post-transplant.

Period covered by references: up to 2000
Search method: not further specified literature search
Website: http://ndt.oxfordjournals.org/content/vol15/suppl_7/index.dtl

Name: European Best Practice Guidelines for Transplantation Part 2

Coordinator: F Berthoux (France)
Reference: Nephrol Dial Transplant, 17 (Suppl 4), 1-67, 2002
Subtopics:

4) Long-term management of the transplant recipient.

Period covered by references: up to 2002
Search method: not further specified literature search
Website: http://ndt.oxfordjournals.org/content/vol17/suppl_4/index.dtl

Planned guidelines:
None: The full area has been covered.

Further guidelines or updates:
Yearly updates are planned on the website

Implementation:
Guideline quiz: e-journal of Nephrol Dial Transplant

EUROPEAN BEST PRACTICE GUIDELINES FOR PERITONEAL DIALYSIS

Published guidelines:
None

Planned guidelines:

Name: European Best Practice Guidelines for Peritoneal Dialysis

Coordinator: R Krediet (the Netherlands)
Start preparation: September 1999
Planned finalisation: ???
Subtopics:

1) General guidelines;
2) The initiation of dialysis;
3) Peritoneal access;
4) Continuous ambulatory peritoneal dialysis delivery systems;
5) Peritoneal dialysis solutions;
6) Automated peritoneal dialysis;
7) Adequacy of peritoneal dialysis;
8) Nutrition in peritoneal dialysis;
9) Peritonitis management;
10) Renal osteodystrophy and management;
11) Peritoneal dialysis and transplantation.

Period covered by references: up to 2003
Search method: Pubmed or similar
Website: Not yet available

Further guidelines or updates:
Not yet planned.

Implementation:
Presentation of EBPG-PD at International meetings: ERA-EDTA Nice 2000, EUROPD Brussels 2002, planned for ISPD/EUROPD Amsterdam 2004
Distribution booklets with résumé guidelines: Distribution small booklet with rationale EBPG-PD at the occasion of the 2002 EUROPD meeting
Guideline quiz: guidelines should be published first

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BRITISH GUIDELINES: PRESENT STATUS

DEPARTMENT OF HEALTH (ENGLAND) GUIDELINES : PRESENT STATUS

Published guidelines:

Name: The National Service Framework for Renal Services Part 1 : Dialysis and Transplantation

Co-ordinator: Renal Team, Department of Health, London
Reference: The National Service Framework for Renal Services, Part 1 : Dialysis and Transplantation, Department of Health, London, England, January 2004
Sub topics:

1) A patient centered service,
2) preparation and choice,
3) elective dialysis access surgery,
4) dialysis,
5) transplantation

Period covered by references: Up to 2003
Search method: Literature searching and data extraction carried out by the York Centre for Reviews and Dissemination, systematic reviews produced by University of Aberdeen, Applied Renal Research Group
Website: www.doh.gov.uk/nsf/renal/index.htm

Planned guidelines:

Part 2 : Acute Renal Failure, End of Life Management, and Early Chronic Renal Failure are under preparation.

Further guidelines or update: Not applicable
Implementation: See Chapter 3 of National Service Framework entitled "Next Steps in implementing this NSF", specifically: "Steps to Take by 2006" and Chapter 4 "Commissioning for Success by 2014"

SCOTTISH EXECUTIVE DEPARTMENT OF HEALTH GUIDELINES: PRESENT STATUS

Published guidelines:

Name: Clinical Standards for Adult Renal Services

Co-ordinator: National Heath Service Quality Improvement Scotland
Reference: Clinical Standards for Adult Renal Services, NHS Quality Improvement Scotland, March 2003
Sub topics:

1) Haemodialysis,
2) peritoneal dialysis,
3) haemoglobin in patients on dialysis,
4) dialysis access,
5) nutritional status,
6) drug therapy,
7) access to multi disciplinary team,
8) assessment for transplantation,
9) kidney retrieval,
10) survival rates,
11) out-patients,
12) provision of patient information,
13) transportation for haemodialysis,
14) audit information and data collection.

Period covered by references: 2002
Search method: Unknown
Website: www.clinicalstandards.org

Planned guidelines: None planned at present
Further guidelines or update: Under discussion at present
Implementation: This document formed the basis of peer reviewed carried out by NHS Quality Improvement Scotland. The fourteen standards were monitored using data from the Scottish Renal Registry and by peer review visits to each renal unit in Scotland. A report was published on www.nhshealthquality.org which included recommendations to hospitals supporting renal units.

RENAL ASSOCIATION (UK) GUIDELINES : PRESENT STATUS

Published guidelines:

Name: Treatment of Adults and Children with Renal Failure -Standards and Audit Measures. 3rd Edition

Co-ordinator: D Wheeler
Reference: Renal Association Standards & Audit Subcommittee "Treatment of Adults & Children with Renal Failure - Standards and Audit Measures" 3rd Ed, London: Royal College of Physicians, 2002
Sub-topics:

1) Methods of guideline development;
2) epidemiology of chronic renal failure &
3) renal replacement therapy;
4) haemodialysis - clinical standards and targets;
5) peritoneal dialysis;
6) haemodialysis and peritoneal dialysis - nutritional and biochemical standards;
7) cardiovascular risk factors in patients on dialysis;
8) anaemia in patients with chronic renal failure;
9) transplantation;
10) blood-borne viruses and microbiology in the renal unit;
11) the management of patients approaching end stage renal disease;
12) acute renal failure.
 

Period covered by references: Up to 2001
Search method: ?? author's own searches
Website: www.renal.org/Standards/standards.html

Planned guidelines: Rolling programme of guidelines for each subtopic planned - authors yet to be decided
Further guidelines: as above
Implementation:

• Currently in use for preparation of National Service Framework for Renal Services in the UK
• Already used to develop clinical standards for Adult Renal Services in Scotland under the NHS Quality Improvement Scotland initiative
• Distributed to all renal units within the UK
• Available on the Renal Association website
• Presentation at national and international meetings

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