Contact: Emily Howell
KDIGO Reports on CKD Staging and Prognosis Project
Orlando, FL (April 15, 2010) – Kidney Disease: Improving Global Outcomes (KDIGO) will present a special session on chronic kidney disease (CKD) definition, staging, and prognosis during the National Kidney Foundation’s (NKF) 2010 Spring Clinical Meetings held here. The KDIGO Data Consortium, led by evidence review teams from the University of Groningen in The Netherlands, and Johns Hopkins University in the US, presented its initial findings during KDIGO’s fall Controversies Conference, where over fifty cohorts with more than 1.5 million study participants submitted data for review. In the last six months, the Consortium has reviewed the massive collection of data relevant to the topic of CKD diagnosis and prognosis which KDIGO will report on today.
The major findings from the Controversies Conference were:
- Emphasize classification by cause, if known, in addition to stage.
- Add albuminuria stages, in addition to Glomerular Filtration Rate (GFR) stages (Albumin-to-Creatinine Ratio (ACR) > 30mg/g, 30-300 mg/g and >300 mg/g).
- Subdivide CKD Stage 3 into two stages (GFR 30-44 and 45-59 ml/min/1.73m2).
“The current findings are generally the same. We corrected smaller errors and updated some data as well as added more analyses. Overall, the findings are similar to but a little stronger than what we originally discovered,” says Josef Coresh, MD of Johns Hopkins University and the conference co-chair who will present on the analytical teams’ progress.
According to Andrew Levey, MD, conference chair and Chief, Division of Nephrology at Tufts University School of Medicine, "The Consortium succeeded in getting much of the world's data on prognosis of chronic kidney disease analyzed using a uniform analytic plan for five different outcomes. Over 40 cohorts completed an updated analysis and examined the risk of cardiovascular and all-cause mortality as well as end-stage kidney disease, acute kidney injury and progressive chronic kidney disease. These analysis focused on examining both estimated kidney filtration function and albuminuria (protein in the urine). Previously most of the literature examined each marker of kidney disease alone and it has become clear that we need to look at both markers together. The meeting attendees agreed that information from both markers should be integrated in updating the CKD staging system and that an additional dimension of risk stratification will be useful. Updating the guidelines requires a broad process of evidence review and more questions will come up but the four upcoming papers from the meeting should put us well on the road to having rigorous data to move forward with CKD staging and risk stratification.”
Researchers from the two Universities manage the collection by reviewing the data and plan to write a series of four meta-analysis papers. Dr. Coresh adds, “The first paper was submitted and the other three data papers and summary paper will be submitted to Kidney International in the next few weeks.”
KDIGO Guideline Development Process
KDIGO is a global organization, managed by the National Kidney Foundation (NKF), with the mission to improve patient care and outcomes through the development and implementation of evidence-based clinical practice guidelines.
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 in Kidney International.