Priority topics for European multidisciplinary guidelines on the management of chronic kidney disease in older adults
- 287 Downloads
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.
KeywordsAged Aged, 80, and over Renal insufficiency, chronic Practice guidelines as topic Consensus
Compliance with ethical standards
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 (http://european-renal-best-practice.org). All authors declare that they have no conflict of interest.
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.
- 1.ERA-EDTA (2014) ERA-EDTA Registry Annual Report 2012. The Netherlands, AmsterdamGoogle Scholar
- 11.Eccles MP, Grimshaw JM, Shekelle P et al (2012) Developing clinical practice guidelines: target audiences, identifying topics for guidelines, guideline group composition and functioning and conflicts of interest. Implement Sci 7:60. doi: 10.1186/1748-5908-7-60 CrossRefPubMedPubMedCentralGoogle Scholar
- 16.Renal Physicians Association (2010) Clinical practice guideline on shared decision-making in the appropriate initiation of and withdrawal from dialysis (2nd ed). Available www.renalmd.org
- 20.Douglas C, Murtagh FEM, Chambers EJ et al (2009) Symptom management for the adult patient dying with advanced chronic kidney disease: a review of the literature and development of evidence-based guidelines by a United Kingdom Expert Consensus Group. Palliat Med 23:103–110. doi: 10.1177/0269216308100247 CrossRefPubMedGoogle Scholar
- 23.Weisshaar E, Szepietowski J, Darsow U et al (2014) European dermatology forum update of the guideline on chronic pruritus. European Dermatology ForumGoogle Scholar
- 24.Graham R, Mancher M, Wolman DM et al (2011) Institute of medicine: clinical practice guidelines we can trust. National Academies Press, Washington, pp 1–13Google Scholar