International Urology and Nephrology

, Volume 48, Issue 6, pp 859–869 | Cite as

Priority topics for European multidisciplinary guidelines on the management of chronic kidney disease in older adults

  • Sabine N. van der VeerEmail author
  • Wim van Biesen
  • Pascale Bernaert
  • Davide Bolignano
  • Edwina A. Brown
  • Adrian Covic
  • Ken Farrington
  • Kitty J. Jager
  • Jeroen Kooman
  • Juan F. Macías-Núñez
  • Andrew Mooney
  • Barbara C. van Munster
  • Eva Topinkova
  • Nele J. A. Van Den Noortgate
  • Gerhard Wirnsberger
  • Jean-Pierre Michel
  • Ionut Nistor
Nephrology - Original Paper



To identify and prioritize potential topics to be addressed in the development of European multidisciplinary guidelines on the management of chronic kidney disease stage 3b–5 in older patients.


We composed a list of 47 potential guideline topics by reviewing the literature, consulting online 461 nephrologists and 107 geriatricians, and obtaining expert input. A multidisciplinary panel of twelve experts then prioritized the topics during a face-to-face consensus meeting, following a nominal group technique structure with two voting rounds. Topics were rated on a 9-point scale ranging from 1 (‘not at all important’) to 9 (‘critically important’).


The highest rating (median; range) was assigned to ‘Screening and referral’ (8.5; 2.0). Eight topics shared the second highest rating with a median priority score of 8.0 (2.0) and included ‘Starting dialysis or not’ and ‘Accurate assessment of renal function.’ ‘Targets for and treatment of diabetes’ received the lowest rating with (3.0; 6.0).


This joint initiative of the European Renal Association–European Dialysis Transplant Association (ERA–EDTA) and the European Union Geriatric Medicine Society (EUGMS) prioritized the development of guidance on interdisciplinary referral of older patients with chronic kidney disease stage 3b–5. Future guidance will therefore focus on identifying prognostic scores to predict death and progression to end-stage renal disease, as well as accurate tests for assessment of renal function in older kidney patients. This will contribute to more informed treatment decision making in this growing patient population.


Aged Aged, 80, and over Renal insufficiency, chronic Practice guidelines as topic Consensus 


Compliance with ethical standards

Ethical standard

This initiative was financially endorsed by the European Renal Association–European Dialysis and Transplant Association (ERA–EDTA). SvdV and IN are ERA–EDTA-funded research fellows working on renal guideline development as members of the Methods Support Team of European Renal Best Practice ( All authors declare that they have no conflict of interest.

Informed consent

Informed consent was obtained from all experts participating in the study. The procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments.

Human and animal right statement

This article does not contain any studies with animals performed by any of the authors.


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Copyright information

© Springer Science+Business Media Dordrecht 2016

Authors and Affiliations

  • Sabine N. van der Veer
    • 1
    • 17
    Email author
  • Wim van Biesen
    • 1
    • 2
  • Pascale Bernaert
    • 3
  • Davide Bolignano
    • 1
    • 4
  • Edwina A. Brown
    • 5
  • Adrian Covic
    • 6
  • Ken Farrington
    • 7
  • Kitty J. Jager
    • 8
  • Jeroen Kooman
    • 9
  • Juan F. Macías-Núñez
    • 10
  • Andrew Mooney
    • 11
  • Barbara C. van Munster
    • 12
  • Eva Topinkova
    • 13
  • Nele J. A. Van Den Noortgate
    • 15
  • Gerhard Wirnsberger
    • 14
  • Jean-Pierre Michel
    • 16
  • Ionut Nistor
    • 1
    • 6
  1. 1.European Renal Best Practice Methods Support TeamGhent University HospitalGhentBelgium
  2. 2.Renal DivisionGhent University HospitalGhentBelgium
  3. 3.Nephrology DepartmentAZ Maria Middelares HospitalGhentBelgium
  4. 4.CNR-Institute of Clinical PhysiologyReggio CalabriaItaly
  5. 5.Imperial College Renal and Transplant CentreHammersmith HospitalLondonUK
  6. 6.Nephrology DepartmentGr. T. Popa University of Medicine and PharmacyIasiRomania
  7. 7.Renal UnitLister HospitalStevenageUK
  8. 8.ERA-EDTA Registry, Department of Medical InformaticsAcademic Medical CenterAmsterdamThe Netherlands
  9. 9.Division of Nephrology, Department of Internal MedicineUniversity Hospital MaastrichtMaastrichtThe Netherlands
  10. 10.Faculty of MedicineUniversity of SalamancaSalamancaSpain
  11. 11.Renal Unit, St James’s University HospitalLeeds Teaching Hospitals NHS TrustLeedsUK
  12. 12.Department of Internal Medicine, University Center of Geriatric MedicineUniversity Medical Center GroningenGroningenThe Netherlands
  13. 13.Department of Geriatric Medicine, First Faculty of MedicineCharles UniversityPragueCzech Republic
  14. 14.Department of Geriatric MedicineGhent University HospitalGhentBelgium
  15. 15.Division of Nephrology, Department of Internal MedicineMedical University of GrazGrazAustria
  16. 16.University of GenevaGenevaSwitzerland
  17. 17.Health eResearch Centre @ Farr Institute for Health Informatics ResearchUniversity of ManchesterManchesterUK

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