指南
医学
风险评估
系统回顾
批判性评价
重症监护医学
循证医学
梅德林
医疗保健
家庭医学
替代医学
病理
计算机科学
经济
经济增长
法学
计算机安全
政治学
作者
Krista L. Lentine,Bertram L. Kasiske,Andrew S. Levey,Patricia L. Adams,Josefina Alberú,Mohamed A. Bakr,Lorenzo Gallon,Catherine A. Garvey,Sandeep Guleria,Philip Kam‐Tao Li,Dorry L. Segev,Sandra J. Taler,Kazunari Tanabe,Linda Wright,Martin Zeier,Michael Cheung,Amit X. Garg
出处
期刊:Transplantation
[Ovid Technologies (Wolters Kluwer)]
日期:2017-08-01
卷期号:101 (8S): S7-S105
被引量:254
标识
DOI:10.1097/tp.0000000000001769
摘要
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.
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