Kidney Disease: Improving Global Outcomes (KDIGO)

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

KDOQI Advisory Board Chairs: Michael Rocco & Adeera Levin

Guideline Development Process:

Topic selection
Develop of scope of work document
Workgroup selection (multidisciplinary)
Generation of questions to guide literature search
Evidence review
- Exhaustive literature search
- Independent evidence-review team at Tufts-New England Medical Center to ensure methodological rigor
Critical appraisal and grading of evidence by workgroup (3-5 in-person workgroup meeting to promote discussion and consensus)
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.
Three stage review process
- KDOQI Advisory Board
- Professional associations and organizations
- Open Public comment period
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
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	Target Hemoglobin Adult 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	Identifying Patients and Initiating Evaluation Evaluation of Anemia in CKD Hb Range Using ESAs Using Iron Agents Using Pharmacological and Nonpharmacological Adjuvants to ESA Treatment in HD-CKD Transfusion Therapy 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	Screening and Diagnosis of Diabetic Kidney Disease Management of Hyperglycemia and General Diabetes Care in Chronic Kidney Disease Management of Hypertension in Diabetes and Chronic Kidney Disease Management of Dyslipidemia 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	Patient Preparation for Permanent Hemodialysis Access Selection and Placement of Hemodialysis Access Cannulation of Fistulae and Grafts and Accession of Hemodialysis Catheters and Port Catheter Systems Detection of Access Dysfunction: Monitoring, Surveillance, and Diagnostic Testing Treatment of Fistula Complications Treatment of Arteriovenous Graft Complications Prevention and Treatment of Catheter and Port Complications 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	Initiation of Dialysis Peritoneal Dialysis Solute Clearance Targets and Measurements Preservation of Residual Kidney Function Maintenance of Euvolemia Quality Improvement Programs 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	Initiation of Dialysis Methods for Measuring and Expressing the Hemodialysis Dose Methods for Postdialysis Blood Sampling Minimally Adequate Hemodialysis Control of Volume and Blood Pressure Preservation of Residual Kidney Function Quality Improvement Programs 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	Evaluation of Cardiovascular Disease in Adult and Pediatric Patients Coronary Artery Disease Acute Coronary Syndromes Chronic Coronary Artery Disease Valvular Heart Disease Cardiomyopathy (Systolic or Diastolic Dysfunction) Dysrhythmia External Defibrillation Cerebrovascular Disease 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	Evaluation of Calcium and Phosphorus Metabolism Assessment of Bone Disease Associated with CKD Surgical Management of Osteodystrophy Target Serum Phosphorus Levels Management of Dietary Phosphorus Intake in Children with CKD Use of Phosphate Binders in CKD Serum Calcium and Calcium-Phosphorus Product Prevention and Treatment of Vitamin D Insufficiency and Vitamin D Deficiency in CKD Patients Active Vitamin D Therapy in CKD Patients Dialysate Calcium Concentrations Recommendations for the Use of Growth Hormone for Children with CKD Aluminum Overload and Toxicity in CKD Treatment of Aluminum Toxicity Treatment of Bone Disease in CKD Parathyroidectomy in Patients with CKD Metabolic Acidosis 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	Evaluation of Calcium and Phosphorus Metabolism Assessment of Bone Disease Associated with CKD Evaluation of Serum Phosphorus Levels Restriction of Dietary Phosphorus in Patients with CKD Use of Phosphate Binders in CKD Serum Calcium and Calcium-Phosphorus Product Prevention and Treatment of Vitamin D Insufficiency and Vitamin D Deficiency in CKD Patients Vitamin D Therapy in CKD Patients Active Vitamin D Therapy in Patients with Stages 3 and 4 CKD Vitamin D Therapy in Patients on Dialysis Dialysate Calcium Concentrations 2-Microglobulin Amyloidosis Aluminum Overload and Toxicity in CKD Treatment of Aluminum Toxicity Treatment of Bone Disease in CKD Hyperparathyroid (High-Turnover) and Mixed (High-Turnover with Mineralization Defect) Bone Disease Osteomalacia Adynamic Bone Disease Parathyroidectomy in Patients with CKD Metabolic Acidosis 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	Goals of Antihypertensive Therapy in CKD Evaluation of Patients With CKD or Hypertension Measurement of Blood Pressure in Adults Evaluation for Renal Artery Disease Education on Self-Management Behavior Dietary and Other Therapeutic Lifestyle Changes in Adults Pharmacological Therapy: Use of Antihypertensive Agents in CKD Pharmacological Therapy: Diabetic Kidney Disease Pharmacological Therapy: Nondiabetic Kidney Disease Pharmacological Therapy: Kidney Disease in the Kidney Transplant Recipient Use of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in CKD Use of Diuretics in CKD 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)	Introduction Assessment of Dyslipidemias 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.	Chronic Kidney Disease as a Public Health Problem Definition and Classification of Stages of Chronic Kidney Disease Evaluation of Laboratory Measurements for Clinical Assessment of Kidney Disease Association of Level of GFR With Complications in Adults Stratification of Risk for Progression of Kidney Disease and Development of Cardiovascular Disease Recommendations for Clinical Performance Measures 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 Evaluation of Protein-Energy Nutritional Status Management of Acid-Base Status Management of Protein and Energy Intake Nutritional Counselling and Follow-Up Carnitine Advance Chronic Renal Failure Without Dialysis Pediatric Guidelines.	Jan. 2001	Chair: Joel D. Kopple Complete workgroup membership

Mission Statement:

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