Clinical practice guidelines for acute kidney injury: a systematic review of the methodological quality.
A systematic review appraising clinical practice guidelines for acute kidney injury found generally moderate methodological and reporting quality, identifying the 2012 KDIGO guideline as the highest-quality AKI framework while flagging persistent gaps in applicability and transparency.
Background
Hospitalized patients, particularly those in the ICU, face a significant risk of acute kidney injury (AKI). Clinical practice guidelines outlining diagnosis and management are valuable tools, but their usefulness depends on their methodological quality, which had not been systematically appraised across the available AKI guidance.
Key recommendations
The reviewers searched PubMed and related databases for AKI guidelines and expert consensus documents published between 2012 and 2023, appraising them with the AGREE II and RIGHT tools. Eight guidelines from six countries and regions were included. On methodological quality, one guideline was rated strongly recommended and six were rated level B (generally recommended). The 2012 KDIGO guideline was identified as the highest-quality AKI guidance currently available and has driven global standardization of diagnostic criteria.
Clinical implications
While overall reporting completeness was moderate, the analysis revealed critical gaps in contextual transparency, quality-assurance protocols, and practical applicability—particularly regarding implementation strategies tailored to different populations such as the elderly. The authors call for future guideline iterations to prioritize demographic inclusivity and address the diagnostic and management challenges of AKI across varied patient groups.
Category
Research
Source
Front Med (Lausanne)
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