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National Kidney Foundation – Kidney Disease: Outcomes Quality Initiative (KDOQI)

Website: www.kdoqi.org 

KDOQI Advisory Board Chairs: Michael Rocco & Adeera Levin 

Guideline Development Process:

  1. Topic selection
  2. Develop of scope of work document
  3. Workgroup selection (multidisciplinary)
  4. Generation of questions to guide literature search
  5. Evidence review
    1. Exhaustive literature search
    2. Independent evidence-review team at Tufts-New England Medical Center to ensure methodological rigor
  6. Critical appraisal and grading of evidence by workgroup (3-5 in-person workgroup meeting to promote discussion and consensus)
  7. Based on the consensus of the Work Group, a set of guidelines are developed to address areas supported by key findings in the evidence report.
  8. Three stage review process
    1. KDOQI Advisory Board
    2. Professional associations and organizations
    3. Open Public comment period
  9. Workgroup finalizes guidelines and published in peer-reviewed journal

Implementation Activities:
After a guideline is published, there is an extensive distribution and implementation of the guideline coordinated through the NKF’s Kidney Learning System.

Title/Publication

Topics Covered

Publication Date

Workgroup Chair

Nutrition in Children with CKD

Published: Am J Kidney Dis 53(3) S1-S123 (2009)
  1. Evaluation of Growth and Nutritional Status
  2. Growth
  3. Nutritional Management and Counseling
  4. Energy Requirements and Therapy
  5. Protein Requirements and Therapy
  6. Vitamin and Trace Element Requirements and Therapy
  7. Bone Mineral and Vitamin D Requirements and Therapy
  8. Fluid and Electrolyte Requirements and Therapy
  9. Carnitine
  10. Nutritional Management of Transplant Patients
Mar., 2009 Bradley Warady, MD & Donna Secker

Anemia Management Update
KDOQI Clinical Practice Guideline and Clinical Practice Recommendations for Anemia in Chronic Kidney Disease: 2007 Update of Hemoglobin Target. Am J Kidney Dis 50:471-530, 2007
  1. Target Hemoglobin
    1. Adult
    2. Pediatric

Aug., 2007

Chairs: David B. Van Wyck & Kai-Uwe Eckardt

Anemia Management
KDOQI Clinical Practice Guidelines and Clinical Practice Recommendations for Anemia in Chronic Kidney Disease. Am J Kidney Dis 47:S11-145, 2006
  1. Identifying Patients and Initiating Evaluation
  2. Evaluation of Anemia in CKD
  3. Hb Range
  4. Using ESAs
  5. Using Iron Agents
  6. Using Pharmacological and Nonpharmacological Adjuvants to ESA Treatment in HD-CKD
  7. Transfusion Therapy
  8. Evaluating and Correcting Persistent Failure To Reach or Maintain Intended Hb

May, 2006

Chairs: David B. Van Wyck & Kai-Uwe Eckardt

Complete workgroup membership

Diabetes and Chronic Kidney Disease
KDOQI Clinical Practice Guidelines and Clinical Practice Recommendations for Diabetes and CKD. AJKD, Vol 49, No 2, Suppl 2, Feb 2007: S1-S182

  1. Screening and Diagnosis of Diabetic Kidney Disease
  2. Management of Hyperglycemia and General Diabetes Care in Chronic Kidney Disease
  3. Management of Hypertension in Diabetes and Chronic Kidney Disease
  4. Management of Dyslipidemia in Diabetes and Chronic Kidney Disease
  5. Nutritional Management in Diabetes and Chronic Kidney Disease
  6. Management of Albuminuria in Normotensive Patients With Diabetes and Albuminuria as a Surrogate Marker
  7. Multifaceted Approach to Intervention in Diabetes and Chronic Kidney Disease
  8. Diabetes and Chronic Kidney Disease in Special Populations
  9. Behavioral Self-Management in Diabetes and Chronic Kidney Disease

Feb., 2007

Chairs: Robert G. Nelson & Katherine R. Tuttle

Vascular Access
Clinical practice guidelines for vascular access. AJKD 48 Suppl 1:S248-S273, 2006
  1. Patient Preparation for Permanent Hemodialysis Access
  2. Selection and Placement of Hemodialysis Access
  3. Cannulation of Fistulae and Grafts and Accession of Hemodialysis Catheters and Port Catheter Systems
  4. Detection of Access Dysfunction: Monitoring, Surveillance, and Diagnostic Testing
  5. Treatment of Fistula Complications
  6. Treatment of Arteriovenous Graft Complications
  7. Prevention and Treatment of Catheter and Port Complications
  8. Clinical Outcome Goals

July, 2006

Chairs: Anatole Besarab & Jack Work

Complete workgroup membership

Peritoneal Dialysis
Clinical practice guidelines for peritoneal dialysis adequacy. AJKD 48 Suppl 1:S98-129, 2006
  1. Initiation of Dialysis
  2. Peritoneal Dialysis Solute Clearance Targets and Measurements
  3. Preservation of Residual Kidney Function
  4. Maintenance of Euvolemia
  5. Quality Improvement Programs
  6. Pediatric Peritoneal Dialysis

July, 2006

Chairs: John M. Burkart & Beth Piraino

Complete workgroup membership

Hemodialysis Adequacy
Clinical practice guidelines for hemodialysis adequacy, update 2006. AJKD48 Suppl 1:S2-90, 2006
  1. Initiation of Dialysis
  2. Methods for Measuring and Expressing the Hemodialysis Dose
  3. Methods for Postdialysis Blood Sampling
  4. Minimally Adequate Hemodialysis
  5. Control of Volume and Blood Pressure
  6. Preservation of Residual Kidney Function
  7. Quality Improvement Programs
  8. Pediatric Hemodialysis Prescription and Adequacy

July, 2006

Chairs: Thomas A. Depner & John T. Daugirdas

Complete workgroup membership

Cardiovascular Disease in Dialysis Patients
K/DOQI clinical practice guidelines for cardiovascular disease in dialysis patients. Am J Kidney Dis 45:S1-153, 2005
  1. Evaluation of Cardiovascular Disease in Adult and Pediatric Patients
  2. Coronary Artery Disease
  3. Acute Coronary Syndromes
  4. Chronic Coronary Artery Disease
  5. Valvular Heart Disease
  6. Cardiomyopathy (Systolic or Diastolic Dysfunction)
  7. Dysrhythmia
  8. External Defibrillation
  9. Cerebrovascular Disease
  10. Peripheral Vascular Disease

Apr., 2005 (Update)

Chairs: Alfred K. Cheung & William L. Henrich

Complete workgroup membership

Bone Metabolism and Disease in Chronic Kidney Disease in Children
National Kidney Foundation: KDOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease. Am J Kidney Dis 2006
  1. Evaluation of Calcium and Phosphorus Metabolism
  2. Assessment of Bone Disease Associated with CKD
  3. Surgical Management of Osteodystrophy
  4. Target Serum Phosphorus Levels
  5. Management of Dietary Phosphorus Intake in Children with CKD
  6. Use of Phosphate Binders in CKD
  7. Serum Calcium and Calcium-Phosphorus Product
  8. Prevention and Treatment of Vitamin D Insufficiency and Vitamin D Deficiency in CKD Patients
  9. Active Vitamin D Therapy in CKD Patients
  10. Dialysate Calcium Concentrations
  11. Recommendations for the Use of Growth Hormone for Children with CKD
  12. Aluminum Overload and Toxicity in CKD
  13. Treatment of Aluminum Toxicity
  14. Treatment of Bone Disease in CKD
  15. Parathyroidectomy in Patients with CKD
  16. Metabolic Acidosis
  17. Bone Disease in the Pediatric Kidney Transplant Recipient

 

Chairs: Craig B. Langman & Isidro B. Salusky

Complete workgroup membership

Bone Metabolism and Disease in Chronic Kidney Disease

National Kidney Foundation: K/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease. Am J Kidney Dis 42:1-201, 2003
  1. Evaluation of Calcium and Phosphorus Metabolism
  2. Assessment of Bone Disease Associated with CKD
  3. Evaluation of Serum Phosphorus Levels
  4. Restriction of Dietary Phosphorus in Patients with CKD
  5. Use of Phosphate Binders in CKD
    Serum Calcium and Calcium-Phosphorus Product
  6. Prevention and Treatment of Vitamin D Insufficiency and Vitamin D Deficiency in CKD Patients
  7. Vitamin D Therapy in CKD Patients
  8. Active Vitamin D Therapy in Patients with Stages 3 and 4 CKD
  9. Vitamin D Therapy in Patients on Dialysis
  10. Dialysate Calcium Concentrations
  11. 2-Microglobulin Amyloidosis
  12. Aluminum Overload and Toxicity in CKD
  13. Treatment of Aluminum Toxicity
  14. Treatment of Bone Disease in CKD
  15. Hyperparathyroid (High-Turnover) and Mixed (High-Turnover with Mineralization Defect) Bone Disease
  16. Osteomalacia
  17. Adynamic Bone Disease
  18. Parathyroidectomy in Patients with CKD
  19. Metabolic Acidosis
  20. Bone Disease in the Kidney Transplant Recipient

October, 2004

Chairs: Shaul G. Massry & Jack W. Coburn

Complete workgroup membership

Hypertension and Antihypertensive Agents in Chronic Kidney Disease

K/DOQI clinical practice guidelines on hypertension and antihypertensive agents in chronic kidney disease. Am J Kidney Dis 43:S1-290, 2004
  1. Goals of Antihypertensive Therapy in CKD
  2. Evaluation of Patients With CKD or Hypertension
  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 in Adults
  7. Pharmacological Therapy: Use of Antihypertensive Agents in CKD
  8. Pharmacological Therapy: Diabetic Kidney Disease
  9. Pharmacological Therapy: Nondiabetic Kidney Disease
  10. Pharmacological Therapy: Kidney Disease in the Kidney Transplant Recipient
  11. Use of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in CKD
  12. Use of Diuretics in CKD
  13. Special Considerations in Children

May, 2004

Chairs: Andrew S. Levey & Michael V. Rocco

Complete workgroup membership

Dyslipidemia

Clinical Practice Guidelines for Managing Dyslipidemias in Kidney Transplant Patients
Am J Trans 2004:4 (Suppl. 7)
  1. Introduction
  2. Assessment of Dyslipidemias
  3. Treatment of Dyslipidemias

April, 2003

Chairs: Bertram Kasiske & Fernando G. Cosio
Complete workgroup membership

Chronic Kidney Disease: Evaluation, Classification, and Stratification
NKF: K/DOQI Clinical Practice
Guidelines for Chronic Kidney Disease: Evaluation, Classification and Stratification. AJKD, Vol 39, No 2, Suppl 1 (February), 2002: pp S1-S266.
  1. Chronic Kidney Disease as a Public Health Problem
  2. Definition and Classification of Stages of Chronic Kidney Disease
  3. Evaluation of Laboratory Measurements for Clinical Assessment of Kidney Disease
  4. Association of Level of GFR With Complications in Adults
  5. Stratification of Risk for Progression of Kidney Disease and Development of Cardiovascular Disease
  6. Recommendations for Clinical Performance Measures
  7. Approach to Chronic Kidney Disease Using These Guidelines.

Feb., 2002

Chairs: Andrew S. Levey & Josef Coresh

Complete workgroup membership

Nutrition
NKF: K/DOQI Clinical Practice
Guidelines For Nutrition of Chronic Renal Failure. AJKD, Vol 37, No 1, Suppl 2 (January), 2001: pp S66-70.

Adult Guidelines

Maintenance Dialysis

  1. Evaluation of Protein-Energy Nutritional Status
  2. Management of Acid-Base Status
  3. Management of Protein and Energy Intake
  4. Nutritional Counselling and Follow-Up
  5. Carnitine
Advance Chronic Renal Failure Without Dialysis
Pediatric Guidelines.

Jan. 2001

Chair: Joel D. Kopple

Complete workgroup membership
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