KDIGO Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors.
KDIGO Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors.
复制标题
DOI：
10.1097/tp.0000000000001769
复制
发表时间：
2017-08
期刊：
影响因子：
6.2
通讯作者：
Garg AX
中科院分区：
文献类型：
--
作者：
Lentine KL;Kasiske BL;Levey AS;Adams PL;Alberú J;Bakr MA;Gallon L;Garvey CA;Guleria S;Li PK;Segev DL;Taler SJ;Tanabe K;Wright L;Zeier MG;Cheung M;Garg AX
2017年肾脏病：改善全球结局（KDIGO）关于活体肾脏捐献者评估和护理的临床实践指南旨在帮助评估活体肾脏捐献者候选人并在捐献前，期间和之后提供护理的医疗专业人员。指南制定过程遵循推荐评估、制定和评价等级（GRADE）方法，指南建议基于对相关研究的系统评价，包括对证据质量和建议强度的关键评价。然而，许多建议没有证据或证据审查小组没有系统地寻找证据，因此作为未评级的专家意见建议发布。准则工作组的结论是，应以全面的风险评估办法取代孤立地根据对单一风险因素的评估作出的决定。进行原始数据分析以产生肾衰竭的“概念验证”风险预测模型，以支持供体候选人评价和可辩护的共同决策中的定量风险评估框架。这一框架的基础是同时考虑每个候选人的人口和健康特征。捐赠者候选人评估的过程和框架，沿着捐赠前，捐赠期间和捐赠后的最佳护理建议。证据的局限性进行了讨论，特别是关于缺乏明确的前瞻性研究和临床结局试验。还提供了对未来研究的建议，包括需要继续完善长期风险预测和估计捐赠归因风险的新方法。在引用本文件时，应使用以下格式：肾脏疾病：改善全球结局（KDIGO）活体肾脏捐献者工作组。KDIGO关于活体肾脏捐献者评估和护理的临床实践指南。移植2017;101（增刊8 S）：S1-S109。
The 2017 Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors is intended to assist medical professionals who evaluate living kidney donor candidates and provide care before, during and after donation. The guideline development process followed the Grades of Recommendation Assessment, Development, and Evaluation (GRADE) approach and guideline recommendations are based on systematic reviews of relevant studies that included critical appraisal of the quality of the evidence and the strength of recommendations. However, many recommendations, for which there was no evidence or no systematic search for evidence was undertaken by the Evidence Review Team, were issued as ungraded expert opinion recommendations. The guideline work group concluded that a comprehensive approach to risk assessment should replace decisions based on assessments of single risk factors in isolation. Original data analyses were undertaken to produce a “proof-in-concept” risk-prediction model for kidney failure to support a framework for quantitative risk assessment in the donor candidate evaluation and defensible shared decision making. This framework is grounded in the simultaneous consideration of each candidate's profile of demographic and health characteristics. The processes and framework for the donor candidate evaluation are presented, along with recommendations for optimal care before, during, and after donation. Limitations of the evidence are discussed, especially regarding the lack of definitive prospective studies and clinical outcome trials. Suggestions for future research, including the need for continued refinement of long-term risk prediction and novel approaches to estimating donation-attributable risks, are also provided. In citing this document, the following format should be used: Kidney Disease: Improving Global Outcomes (KDIGO) Living Kidney Donor Work Group. KDIGO Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors. Transplantation. 2017;101(Suppl 8S):S1–S109.