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1、KDOQI CLINICAL PRACTICE GUIDELINE FOR HEMODIALYSIS ADEQUACY: 2015 UPDATE Abstract The National Kidney Foundations Kidney Disease Outcomes Quality Initiative (KDOQI) has provided evidence-based guidelines for all stages of chronic kidney disease (CKD) and related complications since 1997. The 2015 up
2、date of the KDOQI Clinical Practice Guideline for Hemodialysis Adequacy is intended to assist practitioners caring for patients in preparation for and during hemodialysis. The literature reviewed for this update includes clinical trials and observational studies published between 2000 and March 2014
3、. New topics include high-frequency hemodialysis and risks; prescription fl exibility in initiation timing, frequency, duration, and ultrafi ltration rate; and more emphasis on volume and blood pressure control. Appraisal of the quality of the evidence and the strength of recommendations followed th
4、e Grading of Recommendation Assessment, Devel- opment, and Evaluation (GRADE) approach. Limitations of the evidence are discussed and specifi c suggestions are provided for future research. Keywords: Hemodialysis; Clinical Practice Guideline; hemodialysis prescription; hemodialysis frequency; initia
5、tion; adequacy; treatment time; hemofi ltration; urea modeling; evidence-based recommendation; KDOQI. In citing this document, the following format should be used: National Kidney Foundation. KDOQI clinical practice guideline for hemodialysis adequacy: 2015 update. Am J Kidney Dis. 2015;66(5):884-93
6、0. 884Am J Kidney Dis. 2015;66(5):884-930 Work Group Membership Work Group Chairs John T. Daugirdas, MD University of Illinois College of Medicine Chicago, IL Thomas A. Depner, MD University of California, Davis Sacramento, CA Work Group Members Jula Inrig, MD, MHS Duke University Medical Center Yor
7、ba Linda, CA Rajnish Mehrotra, MD University of Washington Division of Nephrology, Harborview Medical Center Seattle, WA Michael V. Rocco, MD, MSCE Wake Forest School of Medicine Winston Salem, NC Rita S. Suri, MD, MSc, FRCPC University of Montreal Montreal, Quebec Daniel E. Weiner, MD, MS Tufts Med
8、ical Center Boston, MA Evidence Review Team University of Minnesota Department of Medicine Minneapolis VA Center for Chronic Disease Outcomes Research, Minneapolis, MN, USA Nancy Greer, PhD, Health Science Specialist Areef Ishani, MD, MS, Chief, Section of Nephrology, Associate Professor of Medicine
9、 Roderick MacDonald, MS, Senior Research Assistant Carin Olson, MD, MS, Medical Editor and Writer Indulis Rutks, BS, Trials Search Coordinator and Research Assistant Yelena Slinin, MD, MS, Assistant Professor of Medicine Timothy J. Wilt, MD, MPH, Professor of Medicine and Project Director Am J Kidne
10、y Dis. 2015;66(5):884-930885 KDOQI Leadership Michael Rocco, MD, MSCE KDOQI Chair Holly Kramer, MD Vice Chair, Research Michael J. Choi, MD Vice Chair, Education Milagros Samaniego-Picota, MD Vice Chair, Policy Paul J. Scheel, MD, MBA Vice Chair, Policy KDOQI Guideline Development Staff Kerry Willis
11、, PhD, Chief Scientifi c Offi cer Jessica Joseph, MBA, Vice President, Scientifi c Activities Laura Brereton, MSc, KDOQI Project Director 886Am J Kidney Dis. 2015;66(5):884-930 NOTICE SECTION I: USE OF THE CLINICAL PRACTICE GUIDELINE This Clinical Practice Guideline document is based upon the best i
12、nformation available as of June 2015. It is designed to provide information and assist decision making. It is not intended to defi ne a standard of care, and should not be construed as one, nor should it be interpreted as prescribing an exclusive course of management. Variations in practice will ine
13、vitably and appropriately occur when clinicians take into account the needs of individual patients, available resources, and limitations unique to an institution or type of practice. Every health care professional making use of these recommendations is responsible for evaluating the appropriateness
14、of applying them in the setting of any particular clinical situation. The recommendations for research contained within this document are general and do not imply a specifi c protocol. SECTION II: DISCLOSURE Kidney Disease Outcomes Quality Initiative (KDOQI) makes every effort to avoid any actual or
15、 reasonably perceived confl icts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the Work Group. All members of the Work Group are required to complete, sign, and submit a disclosure and attestation form showing all s
16、uch relationships that might be perceived or actual confl icts of interest. This document is updated annually and information is adjusted accordingly. All reported information is on fi le at the National Kidney Foundation (NKF). Am J Kidney Dis. 2015;66(5):884-930887 Table of Contents Contents Figures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 889 Abbreviations and Acronyms . . . . . . . . . . . . . . . .
