Guía para Tratamiento de la Enfermedad Renal Crónica

Vigilancia del Proceso de Implementación en Enfermedad Renal Crónica

I Instituto de Evaluación Tecnológica en Salud

9.8. Vigilancia del proceso de implementación

El proceso de vigilancia de la implementación de la guía se presenta en la figura 19. Para supervisar el proceso de implementación, se diseñaron indicadores, según las recomendaciones establecidas.

Los indicadores propuestos están fundamentados en dos metodologías:

1. Metodología del Balanced Score Card, agrupados en dos categorías:

Indicadores de gestión: describen el proceso de implementación de la GPC.
Indicadores de resultado clínico: describen las consecuencias en salud de la implementación de las recomendaciones. Corresponden a aspectos clínicos y asistenciales específicos que los expertos han considerado adecuados para el seguimiento de las recomendaciones propuestas en la GPC.

2. Clasificación de indicadores según la teoría de servicios de salud propuesta por Donabedian, et al.(624, 625), la cual clasifica los indicadores en tres categorías:

a) indicadores de estructura,
b) indicadores de proceso, e
c) indicadores de resultado.

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631. National Clinical Guideline Centre. Anaemia management in chronic kidney disease. Partial update 2015. Clinical Guideline Methods, evidence and recommendations. London: National Institute for Clinical Excellence (NICE); The Royal College of Physicians; 2015.
632. National Institute for Clinical Excellence. Hyperphosphataemia in chronic kidney disease. Management of hyperphosphataemia in patients with stage 4 or 5 chronic kidney disease. NICE clinical guideline 157. Manchester: National Institute for Health and Care Excellence (NICE); 2013.
633. Rocco MV, Soucie JM, Reboussin DM, McClellan WM. Risk factors for hospital utilization in chronic dialysis patients. Southeastern Kidney Council (Network 6). J Am Soc Nephrol. 1996;7(6):889-96.
634. Programa de salud renal Uruguay. Guías de práctica clínica en el diagnóstico y tratamiento de la enfermedad renal crónica. Montevideo (UY)2013. 65 p.
635. Bose B, Badve SV, Hiremath SS, Boudville N, Brown FG, Cass A, et al. Effects of uric acid-lowering therapy on renal outcomes: a systematic review and meta-analysis. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association – European Renal Association. 2014;29(2):406-13.

Instituto de Evaluación Tecnológica en Salud

IETS Colombia - Instituto de Evaluación Tecnológica en Salud. Instituto de Evaluación Tecnológica en Salud. Fue creado en el 2011 según lo estipulado en la Ley 1438, como una corporación sin ánimo de lucro, con participación de entidades públicas y privadas. De acuerdo con el Departamento Administrativo de la Función Pública, nuestro Instituto es una entidad descentralizada del sector de la salud. Es la Agencia Nacional de Evaluación de Tecnología Sanitaria de Colombia, que genera evidencia con rigor científico para soportar la toma de decisiones, promueve el desarrollo de mejores políticas públicas y prácticas asistenciales en salud con el fin de contribuir al mejoramiento de la salud de los colombianos, y a la sostenibilidad del sistema con legitimidad, innovación, calidad, equidad y eficiencia.

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9.8. Vigilancia del proceso de implementación

Los indicadores propuestos están fundamentados en dos metodologías:

Referencias

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2. Kidney Disease: Improving Global Outcomes CKD Work Group. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney international Supplement. 2013;3(1):1-150.

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27. Rule AD, Amer H, Cornell LD, Taler SJ, Cosio FG, Kremers WK, et al. The association between age and nephrosclerosis on renal biopsy among healthy adults. Annals of internal medicine. 2010;152(9):561-7.

28. Barai S, Gambhir S, Prasad N, Sharma RK, Ora M, Kumar A, et al. Levels of GFR and protein-induced hyperfiltration in kidney donors: a single-center experience in India. American journal of kidney diseases : the official journal of the National Kidney Foundation. 2008;51(3):407-14.

30. Jafar TH, Islam M, Jessani S, Bux R, Inker LA, Mariat C, et al. Level and determinants of kidney function in a South Asian population in Pakistan. American journal of kidney diseases : the official journal of the National Kidney Foundation. 2011;58(5):764- 72.

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35. Remuzzi G, Benigni A, Remuzzi A. Mechanisms of progression and regression of renal lesions of chronic nephropathies and diabetes. The Journal of clinical investigation. 2006;116(2):288-96.

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37. Levey AS, Eckardt KU, Tsukamoto Y, Levin A, Coresh J, Rossert J, et al. Definition and classification of chronic kidney disease: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney international. 2005;67(6):2089-100.

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50. Earley A, Miskulin D, Lamb EJ, Levey AS, Uhlig K. Estimating equations for glomerular filtration rate in the era of creatinine standardization: a systematic review. Annals of internal medicine. 2012;156(11):785-95.

51. Levey AS, Coresh J, Greene T, Stevens LA, Zhang YL, Hendriksen S, et al. Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Annals of internal medicine. 2006;145(4):247-54.

52. Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF, 3rd, Feldman HI, et al. A new equation to estimate glomerular filtration rate. Annals of internal medicine. 2009;150(9):604-12.

53. Horio M, Imai E, Yasuda Y, Watanabe T, Matsuo S. Modification of the CKD epidemiology collaboration (CKD-EPI) equation for Japanese: accuracy and use for population estimates. American journal of kidney diseases : the official journal of the National Kidney Foundation. 2010;56(1):32-8.

56. Matsuo S, Imai E, Horio M, Yasuda Y, Tomita K, Nitta K, et al. Revised equations for estimated GFR from serum creatinine in Japan. American journal of kidney diseases : the official journal of the National Kidney Foundation. 2009;53(6):982-92.

57. Levey A, Greene T, Kusek J. A simplified equation to predict glomerular filtration rate from serum creatinine. J Am Soc Nephrol 2000;11:155A.

58. Ma YC, Zuo L, Chen JH, Luo Q, Yu XQ, Li Y, et al. Modified glomerular filtration rate estimating equation for Chinese patients with chronic kidney disease. J Am Soc Nephrol. 2006;17(10):2937-44.

59. Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Annals of internal medicine. 1999;130(6):461-70.

60. Kilpatrick ES, Verrill H. A national audit of estimated glomerular filtration rate and proteinuria reporting in the UK. Annals of clinical biochemistry. 2011;48(Pt 6):558-61.

62. Lane BR, Demirjian S, Weight CJ, Larson BT, Poggio ED, Campbell SC. Performance of the chronic kidney disease-epidemiology study equations for estimating glomerular filtration rate before and after nephrectomy. The Journal of urology. 2010;183(3):896-901.

63. Michels WM, Grootendorst DC, Verduijn M, Elliott EG, Dekker FW, Krediet RT. Performance of the Cockcroft-Gault, MDRD, and new CKD-EPI formulas in relation to GFR, age, and body size. Clinical journal of the American Society of Nephrology : CJASN. 2010;5(6):1003-9.

66. White CA, Akbari A, Doucette S, Fergusson D, Knoll GA. Estimating glomerular filtration rate in kidney transplantation: is the new chronic kidney disease epidemiology collaboration equation any better? Clinical chemistry. 2010;56(3):474-7.

68. Jones GR, Imam SK. Validation of the revised MDRD formula and the original Cockcroft and Gault formula for estimation of the glomerular filtration rate using Australian data. Pathology. 2009;41(4):379-82.

69. Jones GR. Use of the CKD-EPI equation for estimation of GFR in an Australian cohort. Pathology. 2010;42(5):487-8.

70. Cirillo M, Lombardi C, Luciano MG, Bilancio G, Anastasio P, De Santo NG. Estimation of GFR: a comparison of new and established equations. American journal of kidney diseases : the official journal of the National Kidney Foundation. 2010;56(4):802-4.

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