Eknoyan Garabed, Levin Nathan W
Renal Section, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA.
Blood Purif. 2002;20(1):103-8. doi: 10.1159/000046992.
During the course of developing clinical practice guidelines to improve outcomes of dialysis patients, it became evident that there existed an even greater opportunity to improve outcomes for all individuals with kidney disease, from the earliest stage of kidney injury through the entire spectrum of its progression to kidney failure, when replacement therapy becomes necessary. The development and adoption of a public health approach to the progressive course of chronic kidney disease could allow for the application of interventional strategies to prevent the loss of kidney function in some cases, to slow the progression of kidney disease in many others, and to ameliorate the complication or comorbidities in those with progressive kidney disease. In order to respond to this need, a new initiative, termed the Kidney Disease Outcomes Quality Initiative (K/DOQI), was launched in January of 2000. This article summarizes the recommendations of the first three set of clinical practice guidelines being developed under this new initiative: Chronic Kidney Disease: Evaluation, Classification and Stratification; Bone Metabolism and Disease in Chronic Kidney Disease, and Dyslipidemias in Kidney Failure.
在制定改善透析患者治疗效果的临床实践指南过程中，有一点变得很明显，即对于所有肾病患者，从肾脏损伤的最早阶段到其发展至肾衰竭（此时需要进行替代治疗）的整个过程，存在着更大的改善治疗效果的机会。针对慢性肾病的渐进病程制定并采用公共卫生方法，可以在某些情况下应用干预策略来防止肾功能丧失，在许多其他情况下减缓肾病进展，并改善患有进展性肾病患者的并发症或合并症。为了满足这一需求，2000年1月发起了一项名为“肾脏病预后质量倡议（K/DOQI）”的新计划。本文总结了在这一新计划下正在制定的前三套临床实践指南的建议：《慢性肾脏病：评估、分类和分层》；《慢性肾脏病中的骨代谢与疾病》；以及《肾衰竭中的血脂异常》。
