Developing Guidelines for Chronic Kidney Disease: We Should Include All of the Outcomes
Authors: Katrin Uhlig
Journal: Annals of Internal Medicine (2012)

Editorials17 April 2012Developing Guidelines for Chronic Kidney Disease: We Should Include All of the OutcomesKatrin Uhlig, MD, MS and Andrew S. Levey, MDKatrin Uhlig, MD, MSFrom Tufts Medical Center, Boston, MA 02111. and Andrew S. Levey, MDFrom Tufts Medical Center, Boston, MA 02111.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-156-8-201204170-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail This year marks the 10-year anniversary of the publication of the initial Kidney Disease Outcomes Quality Initiative guidelines for chronic kidney disease (CKD) (1). These guidelines have been accepted internationally with minor modification (2) and have led to worldwide recognition of CKD as a public health problem (3). The guidelines define and stage CKD on the basis of glomerular filtration rate (GFR) estimated from serum creatinine as a measure of kidney function and albuminuria as a marker of kidney damage, regardless of the underlying cause. This simple definition and staging system enabled detection of CKD by nonnephrologists and identification of ...References1. National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002;39:S1-266. [PMID: 11904577] MedlineGoogle Scholar2. Levey AS, Eckardt KU, Tsukamoto Y, Levin A, Coresh J, Rossert J, et al. Definition and classification of chronic kidney disease: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int. 2005;67:2089-100. [PMID: 15882252] CrossrefMedlineGoogle Scholar3. Levey AS, Coresh J. Chronic kidney disease. Lancet. 2012;379:165-80. [PMID: 21840587] CrossrefMedlineGoogle Scholar4. 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Fink HA, Ishani A, Taylor BC, Greer NL, MacDonald R, Rossini D, et al. Screening for, monitoring, and treatment of chronic kidney disease stages 1 to 3: a systematic review for the U.S. Preventive Services Task Force and for an American College of Physicians clinical practice guideline. Ann Intern Med. 2012;156:570-81. LinkGoogle Scholar13. Fink HA, Ishani A, Taylor BC, Greer NL, MacDonald R, Rossini D, et al. Chronic Kidney Disease Stages 1–3: Screening, Monitoring, and Treatment. Comparative Effectiveness Review no. 37. (Prepared by the Minnesota Evidence-based Practice Center under contract HHSA 290-2007-10064-I.) AHRQ Publication no. 11(12)-EHC075-EF. Rockville, MD: Agency for Healthcare Research and Quality; 2012. Accessed at www.effectivehealthcare.ahrq.gov/ehc/products/163/809/CER37_ChronicKidney_20120321.pdf on 5 March 2012. Google Scholar14. Sawaya GF, Guirguis-Blake J, LeFevre M, Harris R, Petitti D; U.S. Preventive Services Task Force. Update on the methods of the U.S. Preventive Services Task Force: estimating certainty and magnitude of net benefit. Ann Intern Med. 2007;147:871-5. [PMID: 18087058] LinkGoogle Scholar15. Kidney Disease Outcomes Quality Initiative (K/DOQI). K/DOQI clinical practice guidelines on hypertension and antihypertensive agents in chronic kidney disease. Am J Kidney Dis. 2004;43:S1-290. [PMID: 15114537] MedlineGoogle Scholar16. Strippoli GF, Navaneethan SD, Johnson DW, Perkovic V, Pellegrini F, Nicolucci A, et al. Effects of statins in patients with chronic kidney disease: meta-analysis and meta-regression of randomised controlled trials. BMJ. 2008;336:645-51. [PMID: 18299289] CrossrefMedlineGoogle Scholar17. Badve SV, Roberts MA, Hawley CM, Cass A, Garg AX, Krum H, et al. Effects of beta-adrenergic antagonists in patients with chronic kidney disease: a systematic review and meta-analysis. J Am Coll Cardiol. 2011;58:1152-61. [PMID: 21884954] CrossrefMedlineGoogle Scholar18. Gandhi GY, Murad MH, Fujiyoshi A, Mullan RJ, Flynn DN, Elamin MB, et al. Patient-important outcomes in registered diabetes trials. JAMA. 2008;299:2543-9. [PMID: 18523223] CrossrefMedlineGoogle Scholar19. Uhlig K, Boyd C. Guidelines for the older adult with CKD. Am J Kidney Dis. 2011;58:162-5. [PMID: 21664736] CrossrefMedlineGoogle Scholar20. Bowling CB, O'Hare AM. Managing older adults with CKD: individualized versus disease-based approaches. Am J Kidney Dis. 2012;59:293-302. [PMID: 22189037] CrossrefMedlineGoogle Scholar21. Jain AK, McLeod I, Huo C, Cuerden MS, Akbari A, Tonelli M, et al. When laboratories report estimated glomerular filtration rates in addition to serum creatinines, nephrology consults increase. Kidney Int. 2009;76:318-23. [PMID: 19436331] CrossrefMedlineGoogle Scholar22. Hemmelgarn BR, Zhang J, Manns BJ, James MT, Quinn RR, Ravani P, et al; Alberta Kidney Disease Network. Nephrology visits and health care resource use before and after reporting estimated glomerular filtration rate. JAMA. 2010;303:1151-8. [PMID: 20332400] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Tufts Medical Center, Boston, MA 02111.Acknowledgment: Aghogho Okparavero, MD, provided assistance with the manuscript.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M12-0413.Corresponding Author: Andrew S. Levey, MD, Tufts Medical Center, Box 391, 800 Washington Street, Boston, MA 02111; e-mail, [email protected]org.Current Author Addresses: Drs. Uhlig and Levey: Tufts Medical Center, Box 391, 800 Washington Street, Boston, MA 02111. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoScreening for, Monitoring, and Treatment of Chronic Kidney Disease Stages 1 to 3: A Systematic Review for the U.S. Preventive Services Task Force and for an American College of Physicians Clinical Practice Guideline Howard A. Fink , Areef Ishani , Brent C. Taylor , Nancy L. Greer , Roderick MacDonald , Dominic Rossini , Sameea Sadiq , Srilakshmi Lankireddy , Robert L. Kane , and Timothy J. Wilt Metrics Cited BySeverity of Preoperative Proteinuria is a Risk Factor for Overall Mortality in Patients Undergoing NephrectomyGFR Decline as an End Point for Clinical Trials in CKD: A Scientific Workshop Sponsored by the National Kidney Foundation and the US Food and Drug AdministrationRoutine Screening for CKD Should Be Done in Asymptomatic Adults … SelectivelyStaging and Management of Chronic Kidney DiseaseMapping creatinine- and cystatin C-related white matter brain deficits in the elderlyChapter 1: Definition and classification of CKDReferencesRisk Models to Predict Chronic Kidney Disease and Its Progression: A Systematic ReviewA Decade After the KDOQI CKD GuidelinesRecent Publications on Medications and Pharmacy 17 April 2012Volume 156, Issue 8Page: 599-601KeywordsAcute renal failureCardiovascular diseasesChronic kidney diseaseClinical trialsCreatinineMedical risk factorsRenal diseasesRenal failureResearch reporting guidelinesTreatment guidelines ePublished: 17 April 2012 Issue Published: 17 April 2012 CopyrightCopyright © 2012 by American College of Physicians. 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