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Int Urol Nephrol. 2016 Jun;48(6):859-69. doi: 10.1007/s11255-016-1257-4. Epub 2016 Mar 17.

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

Author information

1
European Renal Best Practice Methods Support Team, Ghent University Hospital, Ghent, Belgium. sabine.vanderveer@manchester.ac.uk.
2
Health eResearch Centre @ Farr Institute for Health Informatics Research, University of Manchester, Vaughan House, Portsmouth Street, Manchester, M13 9GB, UK. sabine.vanderveer@manchester.ac.uk.
3
European Renal Best Practice Methods Support Team, Ghent University Hospital, Ghent, Belgium.
4
Renal Division, Ghent University Hospital, Ghent, Belgium.
5
Nephrology Department, AZ Maria Middelares Hospital, Ghent, Belgium.
6
CNR-Institute of Clinical Physiology, Reggio Calabria, Italy.
7
Imperial College Renal and Transplant Centre, Hammersmith Hospital, London, UK.
8
Nephrology Department, Gr. T. Popa University of Medicine and Pharmacy, Iasi, Romania.
9
Renal Unit, Lister Hospital, Stevenage, Hertfordshire, UK.
10
ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, Amsterdam, The Netherlands.
11
Division of Nephrology, Department of Internal Medicine, University Hospital Maastricht, Maastricht, The Netherlands.
12
Faculty of Medicine, University of Salamanca, Salamanca, Spain.
13
Renal Unit, St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
14
Department of Internal Medicine, University Center of Geriatric Medicine, University Medical Center Groningen, Groningen, The Netherlands.
15
Department of Geriatric Medicine, First Faculty of Medicine, Charles University, Prague, Czech Republic.
16
Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
17
Department of Geriatric Medicine, Ghent University Hospital, Ghent, Belgium.
18
University of Geneva, Geneva, Switzerland.

Abstract

PURPOSE:

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.

METHODS:

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').

RESULTS:

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).

CONCLUSIONS:

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.

KEYWORDS:

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

PMID:
26984833
DOI:
10.1007/s11255-016-1257-4
[Indexed for MEDLINE]

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