KDIGO Overview

Kidney Disease: Improving Global Outcomes Mission Governance Clinical Practice Guidelines Controversies Conferences Guideline Coordination Guideline Implementation Website KDIGO

Kidney Disease: Improving Global Outcomes KDIGO Mission

Kidney Disease: Improving Global Outcomes 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.’

Kidney Disease: Improving Global Outcomes KDIGO Governance

Kidney Disease: Improving Global Outcomes Organizational Structure Board Board of Councelors (retired BOD members) 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 Nominating committee Nominating committee Foundation under Belgium law

Kidney Disease: Improving Global Outcomes KDIGO Board of Directors 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 Co-Chairs: Kai-Uwe Eckardt, MD GERMANY Bertram Kasiske, MD USA

Kidney Disease: Improving Global Outcomes KDIGO Board of Directors 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 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

Kidney Disease: Improving Global Outcomes Executive Committee Co-chairs: Kai-Uwe Eckardt Germany Bertram KasiskeUnited States Past co-chairs:Norbert LameireBelgium Garabed EknoyanUnited States Members: Josef Coresh United States Jonathon Craig Australia Angel de FranciscoSpain Michel JadoulBelgium Nathan LevinUnited States Miguel RiellaBrazil Robert SchrierUnited States Yusuke TsukamotoJapan David WheelerUnited Kingdom

Kidney Disease: Improving Global Outcomes Clinical Practice Guidelines

Kidney Disease: Improving Global Outcomes Guiding Principles for KDIGO Guideline Development Scientific and methodological rigor Interdisciplinary approach Independence of work groups Transparency of the guideline development process

Kidney Disease: Improving Global Outcomes Quality of evidence High AStrength of recom- mendation 1 Corresponds to “strong“ in GRADE Moderate B Low C 2 Corresponds to “weak“ in GRADE Very low D e.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

Kidney Disease: Improving Global Outcomes 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 in Kidney International in December, 2009

Kidney Disease: Improving Global Outcomes 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

Kidney Disease: Improving Global Outcomes 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

Kidney Disease: Improving Global Outcomes Controversies Conferences

Kidney Disease: Improving Global Outcomes 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

Kidney Disease: Improving Global Outcomes 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

Kidney Disease: Improving Global Outcomes Guideline Coordination

Kidney Disease: Improving Global Outcomes 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

Kidney Disease: Improving Global Outcomes Guideline Coordination Liaison Task Force Global Guideline Coordination Group ISN/KDIGO Collaboration Group

Kidney Disease: Improving Global Outcomes Guideline Implementation

Kidney Disease: Improving Global Outcomes 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

Kidney Disease: Improving Global Outcomes 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.

Kidney Disease: Improving Global Outcomes 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

Kidney Disease: Improving Global Outcomes KDIGO Implementation Task Force LEADERREGION Yusuke Tsukamoto (Chair)Asia Pacific Michelle JosephsonNorth America Miguel RiellaLatin America Michel Jadoul Western Europe Andrzej Więcek Eastern Europe Mona Al Rukhaimi Middle East/Africa

Kidney Disease: Improving Global Outcomes 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.

Kidney Disease: Improving Global Outcomes 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. Implementation Task Force

Kidney Disease: Improving Global Outcomes KDIGO Website

Kidney Disease: Improving Global Outcomes Website Resources KDIGO Guidelines: –All published guidelines available –Recommendations translated into multiple languages –Slide presentations Reports from Controversies Conferences –Published position statements –Conference presentations

Kidney Disease: Improving Global Outcomes Website Resources Global Nephrology Guideline Database: –Guideline Overviews by Organization –Guideline Summaries by Clinical Topic

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