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KDIGO Overview

Kidney Disease: Improving Global Outcomes

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• Mission

• Governance

• Clinical Practice Guidelines

• Controversies Conferences

• Guideline Coordination

• Guideline Implementation

• Website

KDIGO


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KDIGO Mission


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KDIGO

An independently incorporated nonprofit foundation, governed by an international board,

with the stated mission to:

‘Improve the care and outcomes of kidney disease patients worldwide through promoting coordination, collaboration, and integration of initiatives to develop and implement clinical

practice guidelines.’


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KDIGO Governance


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Organizational Structure

Board Board

Board of Councelors(retired BOD members)

Board of Councelors(retired BOD members)

Management: National Kidney Foundation

Management: National Kidney Foundation

KDIGO Workgroups- CPG Workgroups- Liaison Task Force- Implementation Task Force

KDIGO Workgroups- CPG Workgroups- Liaison Task Force- Implementation Task Force

Evidence review:Evidence Review Team Tufts NEMC

Evidence review:Evidence Review Team Tufts NEMC

Executive Committee Executive Committee

Nominating committee

Nominating committee

Foundation under Belgium law


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KDIGO Board of Directors

Omar I. Abboud, MD, SUDAN

Sharon Adler, MD, USA

Sharon P. Andreoli, MD, USA

Robert Atkins, MD, AUSTRALIA

Gavin Becker, MD, AUSTRALIA

Fred Brown, MBA, USA

Evelyn Butera, RN, USA

Daniel Cattran, MD, CANADA

Allan Collins, MD, USA

Ricardo Correa-Rotter, MD, MEXICO

Olivier Coustere, Tx Recipient, FRANCE

Adrian Covic, MD, ROMANIA

Jonathon Craig, MD, AUSTRALIA

Angel de Francisco, MD, SPAIN

Paul de Jong, MD, NETHERLANDS

Tilman Drüeke, MD, FRANCE

Garabed Eknoyan, MD, USA

Denis P. Fouque, MD, FRANCE

Mohammed Benghanem Gharbi, MD, MORROCO

Gordon Guyatt, MD, CANADA

Philip Halloran, MD, CANADA

Co-Chairs: Kai-Uwe Eckardt, MD GERMANY Bertram Kasiske, MD USA


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KDIGO Board of DirectorsDavid Harris, MD, AUSTRALIA

Michel Jadoul, BELGIUM

Vivekanand Jha, MD, INDIA

Suhnggwon Kim, MD, KOREA

Martin Kuhlmann, MD, GERMANY

Adeera Levin, MD, CANADA

Nathan Levin, MD, USA

Phillip K.T. Li, MD, HONG KONG

Zhi-Hong Liu, MD, CHINA

Francesco Locatelli, MD, ITALY

Alison MacLeod, MD, UK

Pablo Massari, MD, ARGENTINA

Peter McCullough, MD, USA

Rafique Moosa, MD, SOUTH AFRICA

Miguel C. Riella, MD, BRAZIL

Bernardo Rodriguez-Iturbe, MD,

VENEZUELA

Robert Schrier, MD USA

Trent Tipple, MD,TX Recipient, USA

Yusuke Tsukamoto, MD, JAPAN

Raymond Vanholder, MD, BELGIUM

Giancarlo Viberti, MD, UK

Theodor Vogels, MSW, NETHERLANDS

David Wheeler, MD, UK

Carmine Zoccali, MD, ITALY


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Executive CommitteeCo-chairs: Kai-Uwe Eckardt Germany

Bertram Kasiske United States

Past co-chairs:Norbert Lameire BelgiumGarabed Eknoyan United States

Members: Adeera Levin CanadaNathan Levin United StatesFranceseco Locatelli Italy Alison MacLeod Scotland Miguel Riella Brazil Robert Schrier United States Yusuke Tsukamoto Japan Raymond Vanholder Belgium David Wheeler United Kingdom


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Clinical Practice Guidelines


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Guiding Principles for KDIGO Guideline Development

• Scientific and methodological rigor• Interdisciplinary approach• Independence of work groups• Transparency of the guideline development

process


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Quality of evidence

High A Strength of recom-mendation

1 Corresponds to “strong“ in GRADE Moderate B

Low C 2 Corresponds to “weak“ in GRADE

Very low De.g. (Grade 1C) or (Grade 2D) ……(8 options)

Plus option to include statements that are not graded

• 2 components of final grade: granularity and transparency

• Although quality of evidence influences strength of recommendation, no direct link • “Neutral“ alphanumeric code instead of terms that may be interpreted differently

Grading: The Quality of the Evidence and the Strength of the Recommendation


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Published Clinical Practice Guidelines

• Prevention, Diagnosis, Evaluation, and Treatment of Hepatitis C in CKD– Published in Kidney International in April, 2008

• Diagnosis, Evaluation, Prevention, and Treatment of CKD-MBD– Published in Kidney International in July, 2009

• Care of Kidney Transplant Recipients– Published in the American Journal of Transplantation

in October, 2009; Executive Summary published inKidney International in December, 2009


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Guidelines in Development• Acute Kidney Injury

– Chairs: John Kellum & Norbert Lameire– Anticipated Publication: September, 2010

• Glomerulonephritis– Chairs: John Feehally & Dan Cattran– Anticipated Publication: December, 2010

• Hypertension– Chairs: Gavin Becker & David Wheeler– Anticipated Publication: July, 2011


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Guidelines in Development• Anemia in CKD

– Chairs: John McMurray and Patrick Parfrey– Initiate in March, 2010– Anticipated Publication in 2011

• CKD Classification and Treatment– Chairs: Adeera Levin and Paul Stevens– Initiate in Summer of 2010– Anticipated Publication in 2011/12


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Controversies Conferences


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2010 KDIGO Controversies Conferences

• Drug Prescribing in Kidney Disease:

Initiative for Improved Dosing (May 2010)

Co-chairs: George Aronoff and Patrick Murray

• Cardiovascular Disease in CKD: What is it

and what can we do about it? (October 2010)Co-chairs: Eberhard Ritz and Charles Herzog


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2011 Planned KDIGO Controversies Conferences

• Living Kidney Donor

(March 2011)

• Alternative Dialysis Techniques

(October 2011)


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Guideline Coordination


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Collaborating Guideline Groups

• Canadian Society of Nephrology (CSN) Guidelines• Caring for Australians with Renal Impairment (CARI)

Guidelines - ANZSN• United Kingdom Renal Association Guidelines• European Best Practice (EBPG) Guidelines –

ERA/EDTA• Kidney Disease Outcomes Quality Initiative (KDOQI)

Guidelines – NKF• ISN Guideline Committee


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Guideline Coordination

• Liaison Task Force

• Global Guideline Coordination Group

• ISN/KDIGO Collaboration Group


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Guideline Implementation


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Guideline Implementation

• Publish Guidelines in multiple languages on KDIGO website and in regional journals

• Commentaries from ISN, KDOQI, ERBP, UK-RA, CARI, and CSN

• Develop professional education tools based on KDIGO Guidelines

• KDIGO Implementation Task Force


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Implementation Task Force

The KDIGO Implementation Task Force is

charged with promoting awareness,

dissemination, adoption and clinical

integration of KDIGO Clinical Practice

Guidelines locally, around the world.


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• Task Force divided into 6 regions

• Each Task Force Leader has designated Regional Representatives from the countries within their region

• There will be different approaches to guideline dissemination depending on the region and on the country

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KDIGO Implementation Task Force

LEADER REGION

Yusuke Tsukamoto (Chair) Asia Pacific

Michelle Josephson North America

Miguel Riella Latin America

Michel Jadoul Western Europe

Andrzej Więcek Eastern Europe

Mona Al Rukhaimi Middle East/Africa


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Activities:• Facilitate and increase the number of

presentations on KDIGO guidelines at local, national, and regional meetings.

• Translate and submit guideline translations and executive summaries to regional journals for publication.


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Activities:• Promote integration and adoption of

guidelines into residency training programs.• Assist in developing commentaries / editorials

on KDIGO Guidelines for publication in regional journals.

• Communicate with regional healthcare administrators to promote adoption of practice guidelines.



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KDIGO Website

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Website Resources

• KDIGO Guidelines:– All published guidelines available– Recommendations translated into multiple

languages– Slide presentations

• Reports from Controversies Conferences – Published position statements– Conference presentations


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Website Resources

• Global Nephrology Guideline Database:– Guideline Overviews by Organization

– Guideline Summaries by Clinical Topic

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Thank you

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Technology

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