‘The Renal Association provides a commentary on the relevance and utlility of NICE guidelines to UK practice’
‘The Renal Association provides a commentary on the relevance and utlility of KDIGO guidelines to UK practice’
Draft Guidelines to review
There are now 3 draft guidelines for review that will be available for the next 4 weeks (Published June 2016)
Management of adults with diabetes on the haemodialysis unit
Diabetic nephropathy remains the principal cause of end-stage renal failure (ESRF) in the UK, as elsewhere in the developed world, and patients with diabetes are forming a greater proportion of patients on maintenance hospital haemodialysis. These are a vulnerable group at high risk of adverse cardiovascular outcomes, which is the leading cause of mortality on this population.
Accordingly, people with diabetes and ESRF require improved delivery of care, in particular to overcome the organisational difficulties they face with their care split across a variety of organisations in primary and secondary care.
These national guidelines, the first in this area, are intended to support the practice of all healthcare professionals who care for this vulnerable group of patients, based on the best available evidence or on expert opinion where there is no clear evidence to inform practice. We aim to provide clear advice to clinicians caring for people with diabetes on maintenance haemodialysis and to encourage and improve education for clinicians and patients to promote patient empowerment and self-management.
Please click here to view the Joint guideline.
Tolvaptan for treating autosomal dominant polycystic kidney disease
In October 2015, NICE recommended that Tolvaptan (JINARC®) therapy should be made available for selected patients with Autosomal Dominant Polycystic Kidney Disease (ADPKD) in England and Wales In January 2016, the Scottish Medicines Consortium (SMC) also approved Tolvaptan for use in Scotland. Currently Tolvaptan is being used in Canada, Japan, Korea and Switzerland for ADPKD and has been approved for use in Europe by the European Medicines Agency (EMA).
NICE recommended that patients with ADPKD who may be eligible for treatment must have Stage 2 or 3 chronic kidney disease (CKD) and ‘evidence of rapidly progressing disease’. SMC have approved its use for Stages 1-3 CKD, similar to that recommended by the EMA. The definition and evaluation of ‘rapid progression’ are however not established and have not been stipulated by NICE, SMC or the EMA. The main purpose of this commentary is to address the issue of how to identify patients with evidence of or who are at risk of rapid disease progression.
Click here to view the final version of the commentary
New RA and ART Guideline on Water Treatment Facilities, Dialysis Water and Dialysis Fluid Quality for Haemodialysis and Related Therapies
Please click here to view the joint guideline.