The KDIGO practice guideline on glomerulonephritis: reading between the (guide)lines--application to the individual patient.
The KDIGO guideline for glomerulonephritis is designed to assist health-care providers in treating patients with glomerular diseases. A guideline is not a set of rules but is intended to allow the practitioner to make an informed decision based on the available evidence. Due to its general nature and the variability of strength of the available studies, it is often difficult to directly apply a guideline to the care of an individual patient. This commonly relates to the limited generalizability of the evidence, i.e., does not cover every clinical scenario. To underscore this point, we have introduced within the context of the glomerulonephritis guideline cases with specific features to illustrate the constant need for clinical judgment. These vignettes are intended to demonstrate how the best treatment plans should be individualized and take into account patient preference and clinical acumen, as well as the best available evidence.
Division of Nephrology, Department of Medicine, Columbia University Medical Center, Columbia University, New York, New York 100321, USA. jr55@columbia.edu
Jai
J
Radhakrishnan
Daniel C
DC
Cattran
D019317:Evidence-Based Medicine; D005921:Glomerulonephritis / Q000628:therapy*; D005922:Glomerulonephritis, IGA / Q000628:therapy; D015433:Glomerulonephritis, Membranous / Q000628:therapy; D005923:Glomerulosclerosis, Focal Segmental / Q000628:therapy; D006801:Humans; D008181:Lupus Nephritis / Q000628:therapy; D057240:Patient Preference; D017410:Practice Guidelines as Topic; D057285:Precision Medicine