New Clinical Practice Guidelines for Chronic Kidney Disease: A Framework for K/DOQI

Chronic kidney disease affects millions of individuals in the United States, and millions more are at risk for the development of kidney disease. The National Kidney Foundation (NKF) has recently published 15 clinical practice guidelines (CPGs) for chronic kidney disease under the Kidney/Disease Outcomes Quality Initiative (K/DOQI). This initial set of guidelines creates a framework for additional interventional CPGs currently in development. Importantly, these guidelines define and classify CKD. In addition, recommendations for the clinical assessment of kidney disease are elaborated. In reviewing the guidelines, we find that they follow the basic principles of CPG development and incorporate the essential aspects of CPGs. The validity of the CPGs is limited in some areas because of the paucity of data. Despite their limitations, the current CPGs allow for the development of clinical performance measures and continuous quality improvement in the hopes of improving public health and reducing progression to end-stage renal disease (ESRD).