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AGREEing on clinical practice guidelines for idiopathic steroid-sensitive nephrotic syndrome in children

Khalid Abdulaziz Alhasan1,2, Reem Al Khalifah3, Majed Aloufi4,5

  • 1Pediatric Nephrology Unit, Pediatrics Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Systematic Reviews
|May 11, 2021
PubMed

Insights

This study reviewed clinical practice guidelines for childhood nephrotic syndrome. The KDIGO guideline demonstrated superior methodological quality, making it most suitable for clinical practice.

Area of Science:

  • Pediatric Nephrology
  • Clinical Practice Guidelines
  • Systematic Review

Background:

  • Nephrotic syndrome is a prevalent kidney disease in children globally.
  • Idiopathic steroid-sensitive nephrotic syndrome (SSNS) requires clear clinical guidance.
  • Evaluating the quality of existing SSNS guidelines is crucial for pediatric care.

Purpose of the Study:

  • To critically appraise the quality of recent Clinical Practice Guidelines (CPGs) for pediatric SSNS.
  • To summarize and compare recommendations from selected CPGs.
  • To identify the most methodologically sound guideline for clinical application.

Main Methods:

  • Systematic review of CPGs using bibliographic and guideline databases.
  • Assessment of CPGs using the Appraisal of Guidelines for REsearch & Evaluation II (AGREE-II) instrument.
  • Comparison of guideline recommendations in a practical table.

Main Results:

  • Three CPGs were appraised: KDIGO (2012), JSPN (2014), and AAP (2009).
  • KDIGO and JSPN scored >70% overall, indicating good evidence-based quality.
  • KDIGO, JSPN, and AAP scored 84%, 74%, and 41% in rigor of development, respectively.

Conclusions:

  • The KDIGO CPG exhibited superior methodological quality compared to JSPN and AAP guidelines.
  • JSPN and AAP guidelines also provide relevant recommendations for pediatric SSNS management.
  • The KDIGO guideline is recommended for practical use in managing childhood SSNS.
Abstract

Keywords:
AGREE II InstrumentClinical practice guidelinesNephrotic syndromePediatricsQuality assessmentSystematic review

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