The KDIGO Hypertension Guidelines: What to Expect
The KDIGO Hypertension Guidelines: What to Expect
David Wheeler, MD, FRCP: My name is David Wheeler, and I'm a Nephrologist from University College in London. I'm here to talk about the Kidney Disease Improving Global Outcomes (KDIGO) guideline on the management of blood pressure in patients with chronic kidney disease (CKD). KDIGO is an international organization with the remit of improving outcomes for patients with kidney disease worldwide. One of the major activities of KDIGO is the production of clinical practice guidelines. These guidelines are aimed at nephrologists and other healthcare professionals managing patients with CKD and are relevant in all countries of the world. I was privileged to co-chair a KDIGO guideline on the management of blood pressure in CKD.
My partner was Gavin Becker, a Nephrologist from Melbourne in Australia. We assembled a group of experts and opinion leaders in the field, and we were supported by a group from Tufts University in Boston, who provided us with all the available evidence upon which to base our guidelines. Our work group included individuals who represented JNC8 [Eighth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure], and the International Society of Hypertension. We had 3 meetings during the course of 2010.
The guideline we've produced will be presented at this meeting of the National Kidney Foundation and will go out for public review within the next few days. We're delighted to invite anybody to review the guidelines. Simply log on to the KDIGO Website, register yourself as a reviewer, and critique the documents being produced. This guideline is for healthcare professionals managing patients with CKD.
We've set a generic target blood pressure applicable to most patients with CKD, but also a lower, tighter target for those patients who have other comorbidities and are at higher risk for cardiovascular disease. We've also emphasized individualizing treatment. In some patients, particularly the elderly, it may be difficult to achieve blood pressure targets, and it may better to back off treatments, particularly as side effects become intolerable. We've also covered kidney transplant recipients and patients at the extremes of life, both in the pediatric and the elderly population. There's some good evidence that controlling blood pressure may slow the progression of CKD. It may also reduce the risk for cardiovascular comorbidities, such as heart attacks and strokes.
The guidelines are now out for public review. The review process will last approximately 6 weeks. We'll look at all the feedback, revise the guidelines accordingly, and we hope to submit in August for publication in October 2011.
We were very keen to base these guidelines on the best available evidence. And so we commissioned the evidence review team from Tufts University in Boston, Massachusetts, to find the relevant literature for us, providing them with criteria for their searches. The evidence review team brought this literature to our work group meetings, and we developed our guidelines based almost entirely on what was in the literature. There are some areas where evidence was lacking. In these areas, the work group members formed a consensus. The statements that are based on consensus, rather than on evidence, are clearly indicated in the guideline document.
So, thank you very much for listening to me. I very much hope that you visit the Website, review the guidelines, and provide feedback for us. Thank you very much.
David Wheeler, MD, FRCP: My name is David Wheeler, and I'm a Nephrologist from University College in London. I'm here to talk about the Kidney Disease Improving Global Outcomes (KDIGO) guideline on the management of blood pressure in patients with chronic kidney disease (CKD). KDIGO is an international organization with the remit of improving outcomes for patients with kidney disease worldwide. One of the major activities of KDIGO is the production of clinical practice guidelines. These guidelines are aimed at nephrologists and other healthcare professionals managing patients with CKD and are relevant in all countries of the world. I was privileged to co-chair a KDIGO guideline on the management of blood pressure in CKD.
My partner was Gavin Becker, a Nephrologist from Melbourne in Australia. We assembled a group of experts and opinion leaders in the field, and we were supported by a group from Tufts University in Boston, who provided us with all the available evidence upon which to base our guidelines. Our work group included individuals who represented JNC8 [Eighth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure], and the International Society of Hypertension. We had 3 meetings during the course of 2010.
The guideline we've produced will be presented at this meeting of the National Kidney Foundation and will go out for public review within the next few days. We're delighted to invite anybody to review the guidelines. Simply log on to the KDIGO Website, register yourself as a reviewer, and critique the documents being produced. This guideline is for healthcare professionals managing patients with CKD.
We've set a generic target blood pressure applicable to most patients with CKD, but also a lower, tighter target for those patients who have other comorbidities and are at higher risk for cardiovascular disease. We've also emphasized individualizing treatment. In some patients, particularly the elderly, it may be difficult to achieve blood pressure targets, and it may better to back off treatments, particularly as side effects become intolerable. We've also covered kidney transplant recipients and patients at the extremes of life, both in the pediatric and the elderly population. There's some good evidence that controlling blood pressure may slow the progression of CKD. It may also reduce the risk for cardiovascular comorbidities, such as heart attacks and strokes.
The guidelines are now out for public review. The review process will last approximately 6 weeks. We'll look at all the feedback, revise the guidelines accordingly, and we hope to submit in August for publication in October 2011.
We were very keen to base these guidelines on the best available evidence. And so we commissioned the evidence review team from Tufts University in Boston, Massachusetts, to find the relevant literature for us, providing them with criteria for their searches. The evidence review team brought this literature to our work group meetings, and we developed our guidelines based almost entirely on what was in the literature. There are some areas where evidence was lacking. In these areas, the work group members formed a consensus. The statements that are based on consensus, rather than on evidence, are clearly indicated in the guideline document.
So, thank you very much for listening to me. I very much hope that you visit the Website, review the guidelines, and provide feedback for us. Thank you very much.
