NKF reviews KDIGO guideline on evaluation of candidates for kidney transplantation
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The National Kidney Foundation’s Kidney Disease Outcomes Quality Initiative has released a commentary on the Kidney Disease: Improving Global Outcomes clinical practice guideline for evaluating and managing kidney transplant candidates.
A workgroup of transplant nephrologists constructed the review of the 2020 guideline, in which they highlighted areas requiring further research and provided specific recommendations, according to a press release from the NKF.
“We endorsed these KDIGO guidelines for evaluating transplant recipients, but our new commentary went beyond what has been published in specific areas,” lead author Sundaram Hariharan, MD, professor of medicine and surgery at the University of Pittsburgh Medical Center, said in the release. “Kidney transplantation is the gold standard treatment option for patients with kidney failure and offers the best chance of improving both quality and quantity of life but requires careful consideration of the risk and benefits. Therefore, it is important that even ‘high-risk’ patients be considered. We see a need for further study of ‘high-risk’ patient outcomes in the future.”
In particular, the reviewers called for additional research to examine outcomes for potential transplant recipients who are older or who have obesity, frailty or cardiovascular comorbidities.
The authors also stressed that caution must be applied when considering bariatric surgery as an option that could benefit transplant candidates because, they noted, there is a scarcity of evidence in the area.
Kerry Willis, PhD, chief scientific officer for the NKF, also provided her perspective on the KDOQI workgroup’s guideline review and how the recommendations can be utilized going further.
“This KDOQI commentary highlights the key issues in evaluation and management of transplant candidates in the U.S.,” she said. “It also makes additional recommendations in a number of areas, including improving referral to transplantation, maximizing the use of available organs, and how transplant programs can improve equity of access to transplantation through better education and social support. Our challenge as a patient advocacy organization will be to educate the community on the importance of these recommendations, and how they can be successfully implemented.”
The full commentary was published in the American Journal of Kidney Diseases on March 18, 2021, and can be accessed here: https://www.ajkd.org/article/S0272-6386(20)31197-5/fulltext.
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