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

• Published in: International urology and nephrology 2016-06, Vol.48 (6), p.859-869
• Main Authors: van der Veer, Sabine N., van Biesen, Wim, Bernaert, Pascale, Bolignano, Davide, Brown, Edwina A., Covic, Adrian, Farrington, Ken, Jager, Kitty J., Kooman, Jeroen, Macías-Núñez, Juan F., Mooney, Andrew, van Munster, Barbara C., Topinkova, Eva, Van Den Noortgate, Nele J. A., Wirnsberger, Gerhard, Michel, Jean-Pierre, Nistor, Ionut
• Format: Article
• Language: English
• Subjects: Age Factors; Aged; Aged, 80 and over; Europe; Female; Health Priorities; Humans; Male; Medicine; Medicine & Public Health; Nephrology; Nephrology - Original Paper; Practice Guidelines as Topic; Renal Insufficiency, Chronic - complications; Renal Insufficiency, Chronic - diagnosis; Renal Insufficiency, Chronic - therapy; Urology
• ISSN: 0301-1623; 1573-2584
• 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.