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KDIGO 肾小球肾炎实践指南:从(指南)字里行间看问题——针对个体患者的应用。

The KDIGO practice guideline on glomerulonephritis: reading between the (guide)lines--application to the individual patient.

机构信息

Division of Nephrology, Department of Medicine, Columbia University Medical Center, Columbia University, New York, New York 100321, USA.

出版信息

Kidney Int. 2012 Oct;82(8):840-56. doi: 10.1038/ki.2012.280. Epub 2012 Aug 15.

Abstract

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.

摘要

KDIGO 肾小球肾炎指南旨在帮助医疗保健提供者治疗肾小球疾病患者。指南不是一套规则,而是旨在让从业者根据现有证据做出明智的决策。由于其一般性和现有研究强度的可变性,通常很难将指南直接应用于个体患者的护理。这通常与证据的有限普遍性有关,即没有涵盖每个临床情况。为了强调这一点,我们在肾小球肾炎指南的背景下引入了具有特定特征的病例,以说明临床判断的必要性。这些病例旨在展示如何将最佳治疗计划个体化,并考虑到患者的偏好和临床敏锐度,以及最佳的现有证据。

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