Key stakeholders' perspectives on the development of an early dietary phosphate self-management strategy for children and young people with chronic kidney disease stages 1-3: A modified Delphi consensus process

An early dietary phosphate intervention (EPI) can provide vital medical benefits supporting self-management of chronic kidney disease (CKD) in childhood. To utilise expert consensus to provide early modelling for an EPI to guide clinical practice across a paediatric renal network. Forty-eight statements across six domains were constructed following a systematic review and semi-structured interviews with children and young people (CYP), parents and healthcare professionals (HCP). A three-round online Delphi survey with parents and paediatric renal multi-disciplinary healthcare experts was undertaken. Twenty-one experts agreed on 56 statements over three Delphi rounds. Statements were accepted in all six domains: definition of an EPI (2), rationale (12), intended users (3), delivery (14) (when [1], where [3], who [2], how [8]), other considerations (16) and potential concerns (9). Consensus was reached on a definition and a set of guiding principles, providing some early modelling for implementation and future research on the development of an EPI strategy for CYP with CKD.