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ERBP is a body of ERA that disseminates and endorses guidance and statements in nephrology. It also produces projects in collaboration with other ERA bodies and/or societies.
The European Renal Best Practice (ERBP) improves the outcome of patients with kidney disease by enhancing knowledge on managing these patients.
Oct 8, 2012 · A European Renal Best Practice (ERBP) position statement on the Kidney Disease Improving Global Outcomes (KDIGO) Clinical Practice Guidelines on Acute Kidney Injury: Part 1: definitions, conservative management and contrast-induced nephropathy †. The ad-hoc working group of ERBP: , Danilo Fliser. , Maurice Laville. , Adrian Covic. , Denis Fouque. ,
- Danilo Fliser, Maurice Laville, Adrian Covic, Denis Fouque, Raymond Vanholder, Laurent Juillard, Wim...
- 2012
- Chapter 1: Introduction
- Chapter 2: Lifestyle and Pharmacological Treatments
- Chapter 5: Blood Pressure Management in Kidney Transplant Recipients
- Chapter 6: Blood Pressure Management in Children with CKD
- Chapter 7: Blood Pressure Management in Elderly Persons with CKD
- Conclusion
- Conflict of Interest Statement
- Acknowledgements
The ‘Kidney Disease: Improving Global Outcomes’ (KDIGO) guideline for the management of hypertension in chronic kidney disease (CKD) was published in Kidney International in 2012. Developing guidelines on a subject as broad as hypertension is difficult. The task is particularly complex when the guidance relates to hypertension in the CKD populatio...
General strategies and lifestyle modification
In general, the KDIGO GDG did not rely on evidence from the general hypertension literature, except in a few instances such as in the sections on general strategies and lifestyle modification. The KDIGO GDG points out that checking for postural hypotension, encouraging a healthy lifestyle and individualizing treatment should be part of good medical practice. As these common sense aspects of treatment are too often neglected, it is worth emphasizing them in a separate recommendation. Some very...
Blood pressure measurement and targets
Methodological issues of blood pressure measurement in CKD are comparable to those in the general population and therefore were not covered in detail in the KDIGO guideline. Nevertheless, one should bear in mind some important aspects of how blood pressure should be measured when interpreting the recommendations. As almost all RCTs evaluated treatment effects using ‘office’ blood pressure readings, which have been demonstrated to have substantial spontaneous variability over time, the word ‘c...
Other treatment modalities
Recently, renal denervation has been forwarded as a means to lower blood pressure. This technique is in its early stages of development, and evidence on its longer term effects on hard outcomes such as progression of renal function, cardiovascular end points or mortality is limited. The ERBP Work Group suggests that this technique should only be offered in the setting of a well-controlled randomized trial.
In keeping with the KDIGO guideline for kidney transplant recipients, the recommended blood pressure target is ≤130/80 mmHg based on observational data, hence the 2D grading. However, the ERBP Work Group questions whether this is a realistic goal and whether ‘one size fits all’. In an unselected cohort of renal transplant patients from two tertiary...
For adults, the KDIGO GDG recommends the same blood pressure levels for the threshold for starting treatment and for blood pressure targets. For children, it is recommended that blood pressure lowering treatment should be started when blood pressure is above the 90th percentile for height, age and sex, but to a blood pressure target of ≤50th percen...
The HYVET trial has had an important impact on hypertension guidelines, providing evidence to positively recommend anti-hypertensive drug treatment in patients aged 80 years or older. A large prospective meta-analysis, published in the same year as HYVET, showed that patients aged under or over 65 years gain a similar benefit from an achieved bloo...
The KDIGO GDG reviewed all available evidence on the management of hypertension in CKD patients in a rigorous and transparent way. The recommendations were made after applying stringent criteria for data selection and grading the evidence. The ERBP Work group endorses the spirit of the recommendation statements. However, the Work Group also wants t...
F.V. and L.V.B.: none declared. The declarations of R.V., G.L., P.C., A.W., D.F. and W.V.B. can be found at www.European-renal-best-practice.org.
Among the authors, R.V., G.L., E.L., P.C., A.W., D.F. and W.V.B. are members of the ERBP Advisory Board. Other members of the ERBP Advisory Board are D. Abramovicz, J.B. Cannata, A. Covic, K.U. Eckardt, O. Heimburger, K.J. Jager, S. Jenkins, E.J. Lindley, F. Locatelli, G. London, A. Marti, G. Spasovski, J.E. Tattersall, C. Wanner and C. Zoccali. Th...
- Francis Verbeke, Elisabeth Lindley, Lucas Van Bortel, Raymond Vanholder, Gérard London, Pierre Cocha...
- 2014
Sep 29, 2013 · ERBP is a project of ERA-EDTA that produces clinical practice guidelines for patients with kidney disease in Europe. Learn about its 10-step approach, methodology and quality assessment tools for developing evidence-based and transparent guidelines.
- Evi V Nagler, Angela C Webster, Angela C Webster, Davide Bolignano, Maria C Haller, Maria C Haller, ...
- 2014
A European Renal Best Practice (ERBP) position statement on the Kidney Disease Improving Global Outcomes (KDIGO) clinical practice guidelines on acute kidney injury: part 1: definitions, conservative management and contrast-induced nephropathy.
The prime mission of European Renal Best Practice (ERBP) is to improve the outcome of patients with kidney disease in a sustainable way through enhancing the availability of the knowledge on the management of these patients in a format that stimulates its use in clinical practice in Europe.
