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Acute kidney injury in the UK : a replication cohort study of the variation across three regional populations
This work was funded by a grant from the UK's Farr Institute for Health Informatics Research (UKHIRN/XFarrRP001). The Farr Institute is supported by a 10-funder consortium: Arthritis Research UK, the British Heart Foundation, Cancer Research UK, the Economic and Social Research Council, the Engineering and Physical Sciences Research Council, the Medical Research Council, the National Institute of Health Research, the National Institute for Social Care and Health Research (Welsh Assembly Government), the Chief Scientist Office (Scottish Government Health Directorates) and the Wellcome (MRC grant nos. CIPHER MR/K006525/1, HeRC MR/K006665/1, London MR/ K006584/1, Scotland MR/K007017/1). We also acknowledge the data management support of Grampian Data Safe Haven (DaSH) and the associated financial support of NHS Research Scotland, through NHS Grampian investment in the Grampian DaSH. Work on this project was also part funded by Health Care and Research Wales, and by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care Wessex at Southampton NHS Hospitals Foundation Trust. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. SS was supported by a research training fellowship from the Wellcome Trust to study the outcomes of acute kidney injury (WT102729/Z/13/Z). ; Peer reviewed ; Publisher PDF
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Priority topics for European multidisciplinary guidelines on the management of chronic kidney disease in older adults
In: van der Veer , S N , van Biesen , W , Bernaert , P , Bolignano , D , Brown , E A , Covic , A , Farrington , K , Jager , K J , Kooman , J , Macías-Núñez , J F , Mooney , A , van Munster , B C , Topinkova , E , Van Den Noortgate , N J A , Wirnsberger , G , Michel , J-P & Nistor , I 2016 , ' Priority topics for European multidisciplinary guidelines on the management of chronic kidney disease in older adults ' International urology and nephrology , vol 48 , no. 6 , pp. 859-69 . DOI:10.1007/s11255-016-1257-4
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.
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Clinical Practice Guideline on management of older patients with chronic kidney disease stage 3b or higher (eGFR <45 mL/min/1.73 m2):a summary document from the European Renal Best Practice Group
In: Farrington , K , Covic , A , Nistor , I , Aucella , F , Clyne , N , De Vos , L , Findlay , A , Fouque , D , Grodzicki , T , Iyasere , O , Jager , K J , Joosten , H , Macias , J F , Mooney , A , Nagler , E , Nitsch , D , Taal , M , Tattersall , J , Stryckers , M , van Asselt , D , Van den Noortgate , N , van der Veer , S & van Biesen , W 2017 , ' Clinical Practice Guideline on management of older patients with chronic kidney disease stage 3b or higher (eGFR <45 mL/min/1.73 m2) : a summary document from the European Renal Best Practice Group ' , Nephrology Dialysis Transplantation , vol. 32 , no. 1 , pp. 9-16 . https://doi.org/10.1093/ndt/gfw411
The population of patients with moderate and severe CKD is growing. Frail and older patients comprise an increasing proportion. Many studies still exclude this group, so the evidence base is limited. In 2013 the advisory board of ERBP initiated, in collaboration with European Union of Geriatric Medicine Societies (EUGMS), the development of a guideline on the management of older patients with CKD stage 3b or higher (eGFR > 45 mL/min/1.73 m(2)). The full guideline has recently been published and is freely available online and on the website of ERBP (www.european-renal-best-practice.org). This paper summarises main recommendations of the guideline and their underlying rationales.
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Clinical Practice Guideline on management of older patients with chronic kidney disease stage 3b or higher (eGFR<45 mL/min/1.73 m2): a summary document from the European Renal Best Practice Group
The population of patients with moderate and severe CKD is growing. Frail and older patients comprise an increasing proportion. Many studies still exclude this group, so the evidence base is limited. In 2013 the advisory board of ERBP initiated, in collaboration with European Union of Geriatric Medicine Societies (EUGMS), the development of a guideline on the management of older patients with CKD stage 3b or higher (eGFR >45 mL/min/1.73 m2). The full guideline has recently been published and is freely available online and on the website of ERBP (www.european-renal-best-practice.org). This paper summarises main recommendations of the guideline and their underlying rationales.
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