ERBP Clinical Practice Guideline on management of older patients with chronic kidney disease stage 3b or higher eGFR < 45ml/min/1.73 m2)
Abstract
In the last year the new Clinical Practice Guideline on management of older patients with chronic kidney disease (CKD) stage 3b or higher (eGFR <45 mL/min/1.73 m2) was published (futher referred to as Guidelines). The Guidelines were created under the umbrella of the European Renal Association - European Dialysis and Transplant Association (ERA-EDTA) that was represented by the European Renal Best Practice (ERBP) group.
Complete text was published in Nephrology Dialysis Transplantation and it is freely accessible on the Internet, e.g. in Medline database. In the following text we provide a brief summary of the Guidelines intended for a broad spectrum of experts' community.
Its target is providing both source of new information and guideline for solving unclear diagnostic or therapeutic cases in patients of this age with kidney disease. Apart from usual rigorous approach to methodology and data evaluation, the text provides amounts of practical information concerning everyday practice and it is oriented on conclusions important from patients' prognosis point of view.
The Guidelines are divided into eight principal topics that deal with management of older patients with CKD stage 3b or higher: i/ what parameter should be used in older patients to estimate kidney function and for dose adaptation purposes; ii/ what is the most reliable risk model score to predict progression of chronic kidney disease; iii/ what is the most reliable risk prediction model to predict mortality; iv/ what is the best alternative method to asses functional decline; v/ are interventions aimed at increasing functional status of benefit; vi/ which is the best alternative to evaluate nutritional status; vii/ which interventions are effective in improving nutritional status; viii/ what is the benefit of dialysis. Development and publication of the Guidelines undoubtedly contribute to improvement of management of older and frail patients with advanced CKD stages.