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NDT Plus Advance Access originally published online on March 25, 2009
NDT Plus 2009 2(3):213-221; doi:10.1093/ndtplus/sfp035
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© The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

The future of European Nephrology ‘Guidelines’—a declaration of intent by European Renal Best Practice (ERBP)

Raymond Vanholder1, Daniel Abramowicz2, Jorge B. Cannata-Andia3, Valentina Cocchi4, Pierre Cochat5, Adrian Covic6, Kai-Uwe Eckardt7, Denis Fouque8, Olof Heimburger9,10, Simon Jenkins11, Alison MacLeod12, Elisabeth Lindley13, Francesco Locatelli14, Gérard London15, Ana Marti i Monros16, Goce Spasovski17, James Tattersall13, Wim Van Biesen1, Christoph Wanner18, Andrej Wiecek19 and Carmine Zoccali20

1 Nephrology Section, University Hospital, Ghent
2 Département Médico-Chirurgical de Néphrologie, Dialyse et Transplantation, Hôpital Erasme, Brussels, Belgium
3 Servicio de Metabolismo Oseo y Mineral, Instituto Reina Sofia de Investigación, REDinREN–ISCIII, Hospital Universitario Central de Asturias, Universidad de Oviedo, Oviedo, Spain
4 European Renal Association/European Dialysis and Transplantation Association
5 Service de Pédiatrie, Centre De Référence Des Maladies Rénales Rares, Hospices Civils de Lyon et Université de Lyon, Lyon, France
6 Nephrology Dialysis and Transplantation, C. I. Parhon University Hospital, University of Medicine Gr. T. Popa, Iasi, Romania
7 Department of Nephrology and Hypertension, University of Erlangen-Nuremberg, Nuremberg, Germany
8 Département de Néphrologie, Hôpital Edouard-Herriot, Lyon, France
9 Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet
10 Department of Renal Medicine, Karolinska University Hospital, Huddinge, Stockholm, Sweden
11 Patient Representative, Manchester
12 Department of Medicine and Therapeutics, University of Aberdeen, Scotland
13 Department of Renal Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK
14 Department of Nephrology, Dialysis and Renal Transplantation, ‘A. Manzoni’ Hospital, Lecco, Italy
15 INSERM U970, Paris, France
16 Nurse Representative, CHGUV Nephrology Department, Valencia, Spain
17 Department of Nephrology, University Clinical Center, Skopje, Macedonia
18 Division of Nephrology, University Hospital, Würzburg, Germany
19 Department of Nephrology, Endocrinology and Metabolic Diseases, Medical University of Silesia, Katowice, Francesca, Poland
20 Unità Operativa di Nefrologia, Dialisi e Trapianto, Ospedali Riuniti e CNR-IBIM, Reggio Cal 89125, Italy

Correspondence: Correspondence and offprint requests to: Raymond Vanholder; E-mail: raymond.vanholder@ugent.be

Key Words: ERBP • guidelines

Received for publication March 3, 2009. Accepted for publication March 3, 2009.

The first 150 words of the full text of this article appear below.


   Introduction
 
The disparities of medical practice, together with a growing number of possible interventions, have increased the demand for well-conceived guidance for practitioners [1]. However, this development is hampered by the number and quality of scientific studies that test medical hypotheses, which are often unsatisfactory. This is especially true in nephrology, where well-conducted controlled trials are rare [2]. Because patients with renal failure are generally excluded from controlled studies in the general population [3], the development of sufficiently well-founded guidance in nephrology has always been difficult.

With the development of European Best Practice Guidelines (EBPG), the European Renal Association–European Dialysis and Transplantation Association (ERA–EDTA) has created its own guidance-generating process. Similar initiatives have also arisen in the USA (Kidney Disease Outcome Initiative—K/DOQI), Australia (Caring for Australasians with Renal Impairment—CARI), Canada (Canadian Society of Nephrology—CSN), the UK (United Kingdom Renal Association—UKRA), as well as at several . . . [Full Text of this Article]


   Potential future of European nephrology guidance
 

   History of European nephrology guidance initiatives
 

   Outline of further action
 

   A change in scope and philosophy
 

   Definitions
 
Quality of evidence
Strength of guidance statements
Guidance documents

   Direct activities
 
Adaptations of existing ‘guidelines’
Transplantation.
Haemodialysis.
Anticoagulation.
Peritoneal dialysis.
Literature watch
Coverage of new topics
Composition of work groups
Recommendations on off-label therapies/drugs
Relationship with KDIGO and other bodies

   Conceptual changes
 
Literature search
Meta-analyses
Peer review
Public (interested individuals).
Interested societies.
Experts.
ERA–EDTA appointed reviewers.

   Implementation
 
Presentation at ERA–EDTA meetings and other conventions
Publications and availability on websites
CD-ROMs, email blasts
Quiz
Audit
Translation into other languages than English
Abbreviated versions

   Financial support
 

   Supportive structures
 

   Conclusions
 

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