KDIGO Overview

1
KDIGO Overview
2
KDIGO

• Mission
• Governance
• Clinical Practice Guidelines
• Controversies Conferences
• Guideline Coordination
• Guideline Implementation
• Website

3
KDIGO Mission
4
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.

5
KDIGO Governance
6
Organizational Structure
Board of Councelors(retired BOD members)
Nominating committee
Board
Management National Kidney Foundation
Executive Committee

• KDIGO Workgroups
• CPG Workgroups
• Liaison Task Force
• Implementation Task Force

Evidence review Evidence Review Team Tufts NEMC
Foundation under Belgium law
7
KDIGO Board of Directors
Co-Chairs Kai-Uwe Eckardt, MD GERMANY
Bertram Kasiske, MD USA

• Omar I. Abboud, MD, SUDAN
• Sharon Adler, MD, USA
• Rajiv Agarwal, USA
• Sharon P. Andreoli, MD, USA
• Robert Atkins, MD, AUSTRALIA
• Gavin Becker, MD, AUSTRALIA
• Fred Brown, MBA, USA
• Daniel Cattran, MD, CANADA
• Allan Collins, MD, USA
• Josef Coresh, MD, USA
• Ricardo Correa-Rotter, MD, MEXICO

• Adrian Covic, MD, ROMANIA
• Jonathon Craig, MD, AUSTRALIA
• Angel de Francisco, MD, SPAIN
• Paul de Jong, MD, NETHERLANDS
• Tilman Drüeke, MD, FRANCE
• Ana Figueiredo, RN, BRAZIL
• Mohammed Benghanem Gharbi, MD, MORROCO
• Gordon Guyatt, MD, CANADA
• Philip Halloran, MD, CANADA
• David Harris, MD, AUSTRALIA
• Enyu Imai, MD, JAPAN

8
KDIGO Board of Directors

• Bernardo Rodriguez-Iturbe, MD,
• VENEZUELA
• Robert Schrier, MD USA
• Hooi Lai Seong, MD, MALAYSIA
• Justin Silver, MD, ISRAEL
• Lesley Stevens, MD, USA
• Marcello Tonelli, CANADA
• Yusuke Tsukamoto, MD, JAPAN
• Theodor Vogels, MSW, NETHERLANDS
• David Wheeler, MD, UK
• Elena Zakharova, MD, RUSSIA

• Michel Jadoul, MD, BELGIUM
• Simon Jenkins, Patient, UK
• Vivekanand Jha, MD, INDIA
• Suhnggwon Kim, MD, KOREA
• Martin Kuhlmann, MD, GERMANY
• Nathan Levin, MD, USA
• Phillip K.T. Li, MD, HONG KONG
• Zhi-Hong Liu, MD, CHINA
• Pablo Massari, MD, ARGENTINA
• Peter McCullough, MD, USA
• Rafique Moosa, MD, SOUTH AFRICA
• Miguel C. Riella, MD, BRAZIL

9
Executive Committee
Co-chairs Kai-Uwe Eckardt Germany Bertram
Kasiske United States Past co-chairs Norbert
Lameire Belgium Garabed Eknoyan United States
Members Josef Coresh United States Jonathon
Craig Australia Angel de Francisco Spain Mich
el Jadoul Belgium Nathan Levin United
States Miguel Riella Brazil Robert
Schrier United States Yusuke Tsukamoto Japan
David Wheeler United Kingdom
10
Clinical Practice Guidelines
11
Guiding Principles for KDIGO Guideline Development

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

12
Grading The Quality of the Evidence and the
Strength of the Recommendation

• 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

Quality of evidence High A Strength of recom-mendation 1 Corresponds to strong in GRADE
Quality of evidence Moderate B Strength of recom-mendation 1 Corresponds to strong in GRADE
Quality of evidence Low C Strength of recom-mendation 2 Corresponds to weak in GRADE
Quality of evidence Very low D Strength of recom-mendation 2 Corresponds to weak in GRADE
e.g. (Grade 1C) or (Grade 2D) (8 options)
Plus option to include statements that are not
graded
13
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

14
Guidelines in Development

• Acute Kidney Injury
• Chairs John Kellum Norbert Lameire
• Anticipated Publication June, 2011
• Glomerulonephritis
• Chairs John Feehally Dan Cattran
• Anticipated Publication August, 2011
• Blood Pressure in CKD
• Chairs Gavin Becker David Wheeler
• Anticipated Publication October, 2011

15
Guidelines in Development

• Anemia in CKD
• Chairs John McMurray and Patrick Parfrey
• Anticipated Publication November, 2011
• CKD Classification and Treatment
• Chairs Adeera Levin and Paul Stevens
• Anticipated Publication July, 2012
• Lipids in CKD
• Chairs Marcello Tonelli and Christoph Wanner
• Anticipated Publication August, 2013
• Peritoneal Dialysis
• Chairs Philip Li and
• Anticipated Publication 2013

16
Controversies Conferences
17
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
•  

18
2011 Planned KDIGO Controversies Conferences

• Novel Dialysis Techniques (October 2011)
• Co-Chairs Christopher Chan, Nathan Levin and
  Francesco Locatelli
• Diabetes in CKD (March 2012)
• Co-Chairs Mark Molitch and Carl Mogensen

19
Guideline Coordination
20
Collaborating Guideline Groups

• Canadian Society of Nephrology (CSN) Guidelines
• Caring for Australians with Renal Impairment
  (CARI) Guidelines - ANZSN
• United Kingdom Renal Association Guidelines
• European Renal Best Practice (ERBP) ERA/EDTA
• Kidney Disease Outcomes Quality Initiative
  (KDOQI) Guidelines NKF
• ISN Guideline Committee

21
Guideline Coordination

• Liaison Task Force
• Global Guideline Coordination Group
• ISN/KDIGO Collaboration Group

22
Guideline Implementation
23
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

24
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.

25
Implementation Task Force

• 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

Type the Presentation Title here Type the
Presentation Subtitle here
26
KDIGO Implementation Task Force

• LEADER REGION
• Yusuke Tsukamoto (Chair) Asia Pacific
• Michelle Josephson North America
• Miguel Riella Latin America
• Michel Jadoul Western Europe
• Andrzej Wiecek Eastern Europe
• Mona Al Rukhaimi Middle East/Africa

27
Implementation Task Force

• 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.

28
Implementation Task Force

• 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.

29
KDIGO Website www.kdigo.org
30
Website Resources

• KDIGO Guidelines
• All published guidelines available
• Recommendations translated into multiple
  languages
• Slide presentations
• Reports from Controversies Conferences
• Published position statements
• Conference presentations

31
Website Resources

• Global Nephrology Guideline Database
• Guideline Overviews by Organization
• Guideline Summaries by Clinical Topic

32
Thank you