title: Priority topics for European multidisciplinary guidelines on the management of chronic kidney disease in older adults.
abstract: OBJECTIVE
  To identify and prioritize potential topics to be addressed in the development of European multidisciplinary guidelines on the management of chronic kidney disease stage 3b-5 in older patients.
  
  
  METHODS
  We composed a list of 47 potential guideline topics by reviewing the literature, consulting online 461 nephrologists and 107 geriatricians, and obtaining expert input. A multidisciplinary panel of twelve experts then prioritized the topics during a face-to-face consensus meeting, following a nominal group technique structure with two voting rounds. Topics were rated on a 9-point scale ranging from 1 ('not at all important') to 9 ('critically important').
  
  
  RESULTS
  The highest rating (median; range) was assigned to 'Screening and referral' (8.5; 2.0). Eight topics shared the second highest rating with a median priority score of 8.0 (2.0) and included 'Starting dialysis or not' and 'Accurate assessment of renal function.' 'Targets for and treatment of diabetes' received the lowest rating with (3.0; 6.0).
  
  
  CONCLUSIONS
  This joint initiative of the European Renal Association-European Dialysis Transplant Association (ERA-EDTA) and the European Union Geriatric Medicine Society (EUGMS) prioritized the development of guidance on interdisciplinary referral of older patients with chronic kidney disease stage 3b-5. Future guidance will therefore focus on identifying prognostic scores to predict death and progression to end-stage renal disease, as well as accurate tests for assessment of renal function in older kidney patients. This will contribute to more informed treatment decision making in this growing patient population.
authors.affiliation: European Renal Best Practice Methods Support Team, Ghent University Hospital, Ghent, Belgium. sabine.vanderveer@manchester.ac.uk.|Health eResearch Centre @ Farr Institute for Health Informatics Research, University of Manchester, Vaughan House, Portsmouth Street, Manchester, M13 9GB, UK. sabine.vanderveer@manchester.ac.uk.
authors.forename: Sabine N
authors.initials: SN
authors.lastname: van der Veer
authors.affiliation: European Renal Best Practice Methods Support Team, Ghent University Hospital, Ghent, Belgium.|Renal Division, Ghent University Hospital, Ghent, Belgium.
authors.forename: Wim
authors.initials: W
authors.lastname: van Biesen
authors.affiliation: Nephrology Department, AZ Maria Middelares Hospital, Ghent, Belgium.
authors.forename: Pascale
authors.initials: P
authors.lastname: Bernaert
authors.affiliation: European Renal Best Practice Methods Support Team, Ghent University Hospital, Ghent, Belgium.|CNR-Institute of Clinical Physiology, Reggio Calabria, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Bolignano
authors.affiliation: Imperial College Renal and Transplant Centre, Hammersmith Hospital, London, UK.
authors.forename: Edwina A
authors.initials: EA
authors.lastname: Brown
authors.affiliation: Nephrology Department, Gr. T. Popa University of Medicine and Pharmacy, Iasi, Romania.
authors.forename: Adrian
authors.initials: A
authors.lastname: Covic
authors.affiliation: Renal Unit, Lister Hospital, Stevenage, Hertfordshire, UK.
authors.forename: Ken
authors.initials: K
authors.lastname: Farrington
authors.affiliation: ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Kitty J
authors.initials: KJ
authors.lastname: Jager
authors.affiliation: Division of Nephrology, Department of Internal Medicine, University Hospital Maastricht, Maastricht, The Netherlands.
authors.forename: Jeroen
authors.initials: J
authors.lastname: Kooman
authors.affiliation: Faculty of Medicine, University of Salamanca, Salamanca, Spain.
authors.forename: Juan F
authors.initials: JF
authors.lastname: Macías-Núñez
authors.affiliation: Renal Unit, St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Mooney
authors.affiliation: Department of Internal Medicine, University Center of Geriatric Medicine, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Barbara C
authors.initials: BC
authors.lastname: van Munster
authors.affiliation: Department of Geriatric Medicine, First Faculty of Medicine, Charles University, Prague, Czech Republic.
authors.forename: Eva
authors.initials: E
authors.lastname: Topinkova
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
authors.forename: Nele J A
authors.initials: NJ
authors.lastname: Van Den Noortgate
authors.affiliation: Department of Geriatric Medicine, Ghent University Hospital, Ghent, Belgium.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Wirnsberger
authors.affiliation: University of Geneva, Geneva, Switzerland.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Michel
authors.affiliation: European Renal Best Practice Methods Support Team, Ghent University Hospital, Ghent, Belgium.|Nephrology Department, Gr. T. Popa University of Medicine and Pharmacy, Iasi, Romania.
authors.forename: Ionut
authors.initials: I
authors.lastname: Nistor
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005060:Europe; D005260:Female; D006292:Health Priorities; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000175:diagnosis / Q000628:therapy*
keywords: Aged; Aged, 80, and over; Consensus; Practice guidelines as topic; Renal insufficiency, chronic