Kidney Disease: Improving Global Outcomes

KDIGOWHAT IS IT AND WHY IS IT IMPORTANT?

Professor Michel JadoulCliniques universitaires Saint-LucUniversité catholique de Louvain

Brussels, Belgium

DISCLOSURES

Research Support: Amgen, Janssen‐Cilag, MSD, Otsuka, Roche

Lecturing: Abbvie, Amgen, Menarini, MSD, Vifor‐FMCRP

Consulting activities: Astellas, Vifor‐FMCRP, MSD

Travel support: Sanofi‐Genzyme

Other : I have cochaired the 2018 update of the HCV in CKD KDIGO Guideline and am cochair of KDIGO

GLOBAL SCIENCELOCAL CHANGE

Kidney Disease: Improving Global Outcomes

• Clinical Practice Guidelines in Nephrology began in 1995 Under the umbrella of the US National Kidney Foundation (NKF) DOQI – K/DOQI - Produced guidelines through 2002

• Concept of Global Clinical Practice Guidelines explored in 2003 & 2004Concept included forming a new global organizationKDIGO launched in 2004Incorporated in Belgium as a non-profit foundationContinued to be managed by NKF under a service contract

• KDIGO grew through 2012 when it became independentKDIGO became self governed and self financedLed by active volunteers and a small staffOver 1,000 clinicians and scientists have participated

• KDIGO is funded by many sources, is transparent and financially stableNo funding directly from industry for guidelines or guideline updatesFunding is sought for general support, conferences, and implementation activities

KDIGO HISTORY

Garabed Eknoyan, M.D.

KDIGO MISSION

Improving the care and outcomes of patients with kidney disease worldwide through the development and implementation of global 

clinical practice guidelines.

2019 KDIGO LEADERSHIP

Michel Jadoul, Belgium Wolfgang Winkelmayer, USA 

Mustafa Arici, TurkeyTara Chang, USA

John Davis, CEO, USAJohn Gill, Canada

Morgan Grams, USAFan Fan Hou, ChinaKunitoshi Iseki, Japan

Magdalena Madero, MexicoJolanta Malyszko, Poland

Ikechi Okpechi, South AfricaRukshana Shroff, UKLaura Sola, Uruguay

Paul Stevens, Secretary‐Treasurer, UKMarcello Tonelli, Methods Chair, Canada

Suzanne Watnick, USAAngela Webster, Australia

David Wheeler, UKChristina Wyatt, USA

Executive Committee Members:

KDIGO Co‐Chairs:

2019 KDIGO LEADERSHIP

Michel Jadoul, Belgium Wolfgang Winkelmayer, USA 

Mustafa Arici, TurkeyTara Chang, USA

John Davis, CEO, USAJohn Gill, Canada

Morgan Grams, USAFan Fan Hou, ChinaKunitoshi Iseki, Japan

Magdalena Madero, MexicoJolanta Malyszko, Poland

Ikechi Okpechi, South AfricaRukshana Shroff, UKLaura Sola, Uruguay

Paul Stevens, Secretary‐Treasurer, UKMarcello Tonelli, Methods Chair, Canada

Suzanne Watnick, USAAngela Webster, Australia

David Wheeler, UKChristina Wyatt, USA

Executive Committee Members:

KDIGO Co‐Chairs:

• Translate scientific advances into useful clinical practice recommendations and observations.

• Continuously improve its brand representing trusted and usable global scientific information.

• Make the global science available and understandable to clinicians around the world.

• Implement its work through local and regional programs taking into account cultural, economic, language, regulatory and environmental issues.

• Adapt, simplify, prioritize and validate recommendations and observations for clinicians’ use in everyday practice.

KDIGO AIMS TO

KDIGO’s AGENDA• Clinical Practice Guidelines

• KDIGO’s core mission = Development, dissemination and implementation of Guidelines

• Guideline Updates• Evidence based

• Controversies Conferences• Conferences that examine significant topics in nephrology and related disciplines that are not fully

resolved. Over 40 so far. Each results in a published Conference Report, usually in Kidney International. Often a Controversies Conference will prompt development of a guideline.

• Implementation Summits• Gathers KOL’s from a country or region to discuss barriers and opportunities for implementation of

KDIGO recommendations

• Implementation Conferences or sessions• Usually through invitations from regional or national nephrology societies

• Educational Tools• Variety of formats, languages, electronic or print, resource driven

KDIGO Clinical Practice Guidelines

Lipid Management November 2013CKD-MBD Update July 2017

Living Kidney Donors August 2017Hepatitis C Update October 2018

KDIGO GUIDELINES

Hepatitis C April 2008Mineral Bone Disorder July 2009Transplant Recipient Oct 2009

Acute Kidney Injury March 2012

Glomerulonephritis June 2012Anemia August 2012

Blood Pressure in CKD November 2012Diagnosis and Management of CKD January 2013

KDIGO ACTIVITIES • Controversies Conferences

• CKD – CVD Series

• Arrhythmias - 2016

• Heart Failure - 2017

• Coronary Artery Disease - 2018

• Non-Cardiac CVD, Stroke - 2020

• Potassium Management - 2018

• Anemia Series - #1 Dec 2019; #2 Q3 2020

• Dialysis Series

• Dialysis Initiation - 2018

• Blood Pressure and Dialysis - 2019

• Home Dialysis - Q2 2020

• Symptom-Based Complications in Dialysis - 2020

• Acute Kidney Injury - 2019

• Early Identification & Intervention - 2019

• Clinical Practice Guidelines

• Bone and Mineral Metabolism Update - 2017

• Hepatitis C and CKD (“Update”) - 2018

• Transplant Candidate Selection - 2019

• Blood Pressure and CKD Update - Currently Under Development

• Glomerular Diseases Update - Currently Under Development

• Diabetes Guideline - Currently Under Development

KDIGO ImplementationActivities

Examples from the 2017 CKD‐MBD Guideline Update

CKD‐MBD UPDATE ‐ PRESS & COMMENTARIES

CKD‐MBD GUIDELINEUPDATE: IMPLEMENTATION TOOLS

http://kdigo.org/guidelines/ckd-mbd/

• CKD‐MBD Quick Reference Guide

CKD‐MBD GUIDELINEUPDATE: IMPLEMENTATION TOOLS

http://kdigo.org/guidelines/ckd-mbd/

• Summary of 2017 CKD‐MBD Guideline Update Recommendations

• 2017 CKD‐MBD Guideline Update Speaker’s Guide

KDIGO‐ISN WEBINAR

• 73%  Attentiveness 

• 125 Attendees

• 77 Interest Rating

• 604 people registered for this webinar – a very high number, if not a record!

• Summarized 3 years of work in 30 minutes

• 20+ Q&A questions in 15 minutes

• Held June 21, 2017

• Recording available at https://academy.theisn.org

KDIGO CLINICAL PRACTICE GUIDELINES APP

KDIGO Impact

KDIGO GUIDELINES – MOST CITED IN KI SUPPLEMENTS

KDIGO Guidelines are the TOP FIVE MOST CITED ARTICLES in Kidney International Supplements 

The KDIGO conference report on “The definition, classification and prognosis of CKD” is the MOST CITED ARTICLE in Kidney International (658 times)

The 2017 KDIGO conference report on “Screening, diagnosis, and management of patients with Fabry disease” is the FOURTH MOST READ ARTICLE in Kidney International

KDIGO CONFERENCE REPORTS ‐ MOST CITED & MOST READ IN KI

KDIGO  cited in more than 150 textbooks, not just in nephrology 

KDIGO IMPACT

WHAT LIES AHEAD – CHALLENGES & FORWARD VISION• Expand KDIGO’s Guideline portfolio

• Guideline updates near real time

• Drive cutting edge in guideline methodology

• Expand outreach beyond nephrology

• Further increase diversity in all KDIGO Activities

• Better document KDIGO’s impact on populations