Evidence-Based Clinical Practice Guidelines for the Assessment and Management of Chronic Kidney Disease: A Systematic Review and Quality Assessment Using the AGREE II Instrument

Theodor Bilharz Research Institute

Bibliographic Information

Authors: Mohamed M.A.B.; El-Malky A.M.; Amer Y.S.; Abdelkarim W.A.A.; Aabdeen M.A.S.; Ahmed T.H.E.; Sarsour H.H.H.; Mosa M.M.; Khormi A.A.M.; Alghamdi M.A.S.; Nazer R.I.

Journal: Saudi Journal of Kidney Diseases and Transplantation

Publisher: Wolters Kluwer Medknow Publications

Publication Date: 6 December 2025

Volume / Issue: Volume 35 / Issue 2026-01-06 00:00:00

Pages: 80–97

ISSN: 13192442

DOI: 10.4103/sjkdt.sjkdt_127_22

Scopus: View on Scopus

PubMed: 41353097

Document Type: Article

Access: All Open Access; Gold Open Access; Green Open Access

Authors and Affiliations

Mohamed M.A.B., Leeds University Teaching Hospital, Leeds, United Kingdom; El-Malky A.M., Public Health and Community Medicine Department, Theodor Bilharz Research Institute, Academy of Scientific Research, Ministry of Higher Education, Cairo, Egypt, Morbidity and Mortality Review Unit, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia; Amer Y.S., Pediatrics Department, King Khalid University Hospital, Riyadh, Saudi Arabia, King Saud University, Riyadh, Saudi Arabia, Clinical Practice Guidelines and Quality Research Unit, Quality Management Department, King Saud University Medical City, Riyadh, Saudi Arabia, Alexandria Center for Evidence-Based Clinical Practice Guidelines, Alexandria University, Alexandria, Egypt, Adaptation Working Group, Guidelines International Network, Perth, United Kingdom; Abdelkarim W.A.A., Department of Obstetrics and Gynecology, King Saud University Medical City, Riyadh, Saudi Arabia; Aabdeen M.A.S., Pediatric Surgery Department, Paediatric Urology Division, Leeds University Teaching Hospital, Leeds, United Kingdom; Ahmed T.H.E., Trauma and Orthopedic Department, Manchester Royal Infirmary Hospital, Manchester, United Kingdom; Sarsour H.H.H., Mercy Corps Europe, Kadugli, Sudan; Mosa M.M., College of Medicine, King Saud University, King Saud University Medical City, Riyadh, Saudi Arabia; Khormi A.A.M., Internal Medicine and Rheumatology, Prince Sattam University Medical College, AlKharj, Saudi Arabia; Alghamdi M.A.S., College of Medicine and Surgery, University of Tabuk, Tabuk, Saudi Arabia; Nazer R.I., Cardiac Science Department, King Fahad Cardiac Science Center, College of Medicine, King Saud University, King Saud University Medical City, Riyadh, Saudi Arabia

Abstract

Clinical practice guidelines (CPGs) based on evidence and expert opinions ensure that patients with chronic kidney disease (CKD) receive the most up to date care. We aimed to assess and evaluate the most recent and approved international CPGs and compare them via the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. Four independent reviewers appraised the selected guidelines with the AGREE II instrument. We considered five eligible CPGs for critical appraisal: the National Kidney Foundation-Kidney Disease Outcomes Quality Initiative (NKF-K/DOQI) CPGs for CKD, the National Institute for Health and Care Excellence (NICE) guidelines for assessing and managing CKD, the Academy of Nutrition and Dietetics’ CKD evidence-based nutrition practice guidelines, the CPGs of the Ministry of Public Health in Qatar (MOPH/QA), and the Scottish Intercollegiate Guidelines Network’s guidelines for the diagnosis and management of CKD. The overall assessments of three CPGs (NICE, NKF-K/DOQI, and MOPH/QA) scored greater than 85%; the results were congruent with higher scores in the six AGREE II domains: 80%, 67%, and 86% for Domain 3; 47%, 43%, and 86% for Domain 5; and 60%, 48%, and 86% for Domain 6, respectively. Generally, the clinical recommendations were significantly better for the NICE CPGs. All evidence-based CPGs had relatively low methodological quality. The NICE CPGs demonstrated the highest quality, followed by the MOPH/QA and NKF-K/DOQI CPGs, and all five CPGs were recommended for use in practice but with improvements. Saudi Arabia has to formulate its own national CPGs for the diagnosis and management of CKD based on those published by the NICE. © 2024 Saudi Journal of Kidney Diseases and Transplantation.

Keywords

article; chronic kidney failure; clinical practice guideline; diagnosis; dietetics; evidence based practice; female; human; kidney disease; practice guideline; Qatar; quality control; Saudi Arabia; systematic review

Citation Information

Scopus Citations: 0

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