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Chronic kidney disease national clinical guidelines for early identification and management in adults in primary and secondary care.

Chronic kidney disease national clinical guidelines for early identification and management in adults in primary and secondary care. The National Collaborating Centre for Chronic Conditions at the Royal College of Physicians Publisher: Royal College of Physicians of London 11 St Andrews Place, Regent's Park London NW1 4LE


The book was part of the work by the National Collaborating Centre for Chronic Conditions (NCC-CC). The NCC-CC is a collaborative, multiprofessional centre which undertakes commissions to develop clinical guidance for the National Health Service in the UK. The NCC-CC was established in 2001 and is funded by the National Institute for Health and Clinical Excellence (NICE) to undertake commissions for national clinical guidelines on an annual rolling programme.

The main purpose of this book was to provide a reference tool for the recommended guidelines used to treat people with Chronic Kidney Disease (CKD). The book examines the best clinical trials resulting in the Guideline Development Group (GDG) making evidenced-based recommendations. The GDG was comprised of 19 members and other experts who were asked to attend specific meetings. The GDG has a number of nephrologists, general practitioners, scientists, patient representatives, biochemists, health economist, geriatricians and a practice nurse to name a few.

The book is divided up into 15 chapters which cover an introduction, methods and background to the development of the guidelines. Aspects of CKD such as investigations, classification and progress of CKD and specific management principles including blood pressure control, renal bone disease and anaemia are covered in subsequent chapters.

This book would be an excellent resource for all renal units, and would be particularly useful for medical students and doctors new to renal medicine. Not only does the book look at the best published clinical and economic evidence, but provides a comprehensive reference guide as a starting point for further reading. There are currently many more specialist nurses and nurse consultant positions and I feel this book would be a useful tool for nurses who look after and care for patients with CKD. This book would be beneficial if you wished to look at where the evidence came from, for the establishment of the guidelines, or if you were interested in commencing research, then you could look at a particular research area of need.

Some chapters are not discussed in any great depth. For example the important topic of anaemia is covered on one page. However, I still found the book rather heavy reading, as there was a lot of statistical data and abbreviations. I had to persevere to read the whole book. Additionally, the book's recommendations are readily available on renal websites such as the Caring for Australasians with Renal Impairment (CARI) and Kidney disease improving Global Outcomes (KDOQI) as well as the European Dialysis and Transplantation nurses Association (EDTNA).

The EDTNA recently published two pocket size reference books titled Chronic Kidney Disease Stages 1-3 and stages 4-5, A Guide to Clinical practice, which cover the care and management of these patients. See book review Moustakas and Smolonogov RSAJ Vol 4 / Number 3 / October 2008. These books would be an alternative read to the book in this review.

Chapter Headings

* Introduction, methodology and key messages of the guideline

* Investigation of CKD

* Classification and early identification

* Defining progression of CKD and the risk factors associated with progression

* Referral criteria

* Self management

* Blood pressure control

* Reducing cardiovascular disease

* Asymptomatic hyperuricaemia

* Managing isolated microscopic haematuria

* Specific complications of CKD renal bone disease

* Specific complications of CKD anaemia

* Information needs

Debbie J Pugh, Clinical Nurse Specialist, Renal Failure Coordinator, Prince of Wales Hospital, Sydney.
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Author:Pugh, Debbie J.
Publication:Renal Society of Australasia Journal
Article Type:Report
Geographic Code:8AUST
Date:Mar 1, 2009
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