Journal of Traditional Chinese Medicine ›› 2024, Vol. 44 ›› Issue (3): 609-619.DOI: 10.19852/j.cnki.jtcm.20240402.002
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WANG Yuhuang1, ZHANG Le2, ZHANG Zhengshan1, YAO Zhi1, LI Xiyao3, SUN Luying1(), LIAO Xing2()
Received:
2023-02-22
Accepted:
2023-07-15
Online:
2024-06-15
Published:
2024-04-08
Contact:
Prof. SUN Luying, Department of Nephropathy and Endocrine, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100010, China. WANG Yuhuang, ZHANG Le, ZHANG Zhengshan, YAO Zhi, LI Xiyao, SUN Luying, LIAO Xing. Characteristics and quality of clinical practice guidelines for diabetic kidney disease: a systematic review[J]. Journal of Traditional Chinese Medicine, 2024, 44(3): 609-619.
Figure 1 Flow diagram of screening procedure DKD: Diabetic kidney disease; AGREE: Appraisal of Guidelines: Research and Evaluation; CPGs: Clinical practice guidelines.
Name of guidelines | Publication organizations/authors | Country of origin | Publication year | Grading system | Search strategy | Funds | Aim of CPG |
---|---|---|---|---|---|---|---|
Traditional Chinese Medicine Diagnosis and Treatment Standards for Diabetic Kidney Disease | DSCACM | China | 2011 | None | None | Unclear | Diagnosis and treatment of DKD in the field of TCM |
Combining Disease and Syndrome Guideline for Diagnosis and Treatment of Diabetic Kidney Disease | PCEM | China | 2022 | GRADE | Yes, but incomplete | Unclear | Diagnosis and treatment of DKD by combining TCM and conventional medicine |
Clinical guideline for the prevention and treatment of diabetic kidney disease in China (2021 edition) | MCGCDS | China | 2021 | GRADE | None | Unclear | Prevention and treatment of DKD |
Clinical Diagnosis for Adults with Diabetic Kidney Disease: a Chinese Expert Consensus | CSE | China | 2015 | ADA | None | Unclear | Diagnosis of DKD |
Multidisciplinary Expert Consensus on Diagnosis, Treatment and Management of Diabetic Kidney Disease | Jiang SM et al | China | 2020 | None | None | Yes | Recommendations regarding the diagnosis, treatment and management of DKD |
Expert Consensus on the Diagnosis and Management of Diabetic Kidney Disease | DKDCG | China | 2020 | Self-designated | Yes, but incomplete | Yes | Recommendations regarding the diagnosis and management of DKD |
Expert Consensus on early Prediction and Diagnosis of Diabetic Kidney Disease | Zhang JQ et al | China | 2021 | None | None | Yes | Recommendations for early prediction and diagnosis of DKD |
Chinese Guidelines for Diagnosis and Treatment of Diabetic Kidney Disease | CSN | China | 2021 | GRADE | None | Unclear | Recommendations for treatment and diagnosis of DKD |
Expert consensus on Diagnosis, Prognosis Assessment and Application of Biomarkers in Diabetic Kidney Disease | CSN | China | 2022 | GRADE | None | Unclear | Recommendations for diagnosis, prognosis, assessment and application of biomarkers of DKD |
Chinese Guidelines for Renal Replacement Therapy in Diabetic End-stage Renal Disease | CSN | China | 2022 | None | None | Unclear | Recommendations for renal replacement therapy in diabetic end-stage renal disease |
Expert Consensus Statement on Clinical Application of Chinese Patent Medicines for Patients with Diabetic Kidney Disease in Clinical Practice | Wang B et al | China | 2022 | GRADE | Yes, but incomplete | Yes | Recommendations for Chinese Patent Medicines for the treatment of DKD |
Expert Consensus on Medical Nutrition Therapy for Adult Diabetic Kidney Diseases in China | CSE | China | 2022 | Unclear | None | Unclear | Recommendations for medical nutrition treatment of DKD |
Guideline for primary care of diabetes kidney disease in China | CSGP | China | 2023 | GRADE | None | Yes | Recommendations for primary health care of DKD |
Diabetic Nephropathy (update 2019) | Souriji H et al | Austria | 2019 | None | None | Yes | Recommendations for diagnosis and treatment of DKD |
Asian Pacific Society of Nephrology Clinical Practice Guideline on Diabetic Kidney Disease | Liew A et al | Asian | 2020 | GRADE | None | Unclear | Recommendations for diagnosis and treatment of DKD |
Diabetic Kidney Disease: new clinical and therapeutic issues. Joint position statement of the Italian Diabetes Society and the Italian Society of Nephrology on “The natural history of diabetic kidney disease and treatment of hyperglycemia in patients with type 2 diabetes and impaired renal function” | Pugliese G et al | Italy | 2019 | None | None | None | Recommendations for diagnosis and treatment of DKD |
Table 1 Overview of the included CPGs (n = 16)
Name of guidelines | Publication organizations/authors | Country of origin | Publication year | Grading system | Search strategy | Funds | Aim of CPG |
---|---|---|---|---|---|---|---|
Traditional Chinese Medicine Diagnosis and Treatment Standards for Diabetic Kidney Disease | DSCACM | China | 2011 | None | None | Unclear | Diagnosis and treatment of DKD in the field of TCM |
Combining Disease and Syndrome Guideline for Diagnosis and Treatment of Diabetic Kidney Disease | PCEM | China | 2022 | GRADE | Yes, but incomplete | Unclear | Diagnosis and treatment of DKD by combining TCM and conventional medicine |
Clinical guideline for the prevention and treatment of diabetic kidney disease in China (2021 edition) | MCGCDS | China | 2021 | GRADE | None | Unclear | Prevention and treatment of DKD |
Clinical Diagnosis for Adults with Diabetic Kidney Disease: a Chinese Expert Consensus | CSE | China | 2015 | ADA | None | Unclear | Diagnosis of DKD |
Multidisciplinary Expert Consensus on Diagnosis, Treatment and Management of Diabetic Kidney Disease | Jiang SM et al | China | 2020 | None | None | Yes | Recommendations regarding the diagnosis, treatment and management of DKD |
Expert Consensus on the Diagnosis and Management of Diabetic Kidney Disease | DKDCG | China | 2020 | Self-designated | Yes, but incomplete | Yes | Recommendations regarding the diagnosis and management of DKD |
Expert Consensus on early Prediction and Diagnosis of Diabetic Kidney Disease | Zhang JQ et al | China | 2021 | None | None | Yes | Recommendations for early prediction and diagnosis of DKD |
Chinese Guidelines for Diagnosis and Treatment of Diabetic Kidney Disease | CSN | China | 2021 | GRADE | None | Unclear | Recommendations for treatment and diagnosis of DKD |
Expert consensus on Diagnosis, Prognosis Assessment and Application of Biomarkers in Diabetic Kidney Disease | CSN | China | 2022 | GRADE | None | Unclear | Recommendations for diagnosis, prognosis, assessment and application of biomarkers of DKD |
Chinese Guidelines for Renal Replacement Therapy in Diabetic End-stage Renal Disease | CSN | China | 2022 | None | None | Unclear | Recommendations for renal replacement therapy in diabetic end-stage renal disease |
Expert Consensus Statement on Clinical Application of Chinese Patent Medicines for Patients with Diabetic Kidney Disease in Clinical Practice | Wang B et al | China | 2022 | GRADE | Yes, but incomplete | Yes | Recommendations for Chinese Patent Medicines for the treatment of DKD |
Expert Consensus on Medical Nutrition Therapy for Adult Diabetic Kidney Diseases in China | CSE | China | 2022 | Unclear | None | Unclear | Recommendations for medical nutrition treatment of DKD |
Guideline for primary care of diabetes kidney disease in China | CSGP | China | 2023 | GRADE | None | Yes | Recommendations for primary health care of DKD |
Diabetic Nephropathy (update 2019) | Souriji H et al | Austria | 2019 | None | None | Yes | Recommendations for diagnosis and treatment of DKD |
Asian Pacific Society of Nephrology Clinical Practice Guideline on Diabetic Kidney Disease | Liew A et al | Asian | 2020 | GRADE | None | Unclear | Recommendations for diagnosis and treatment of DKD |
Diabetic Kidney Disease: new clinical and therapeutic issues. Joint position statement of the Italian Diabetes Society and the Italian Society of Nephrology on “The natural history of diabetic kidney disease and treatment of hyperglycemia in patients with type 2 diabetes and impaired renal function” | Pugliese G et al | Italy | 2019 | None | None | None | Recommendations for diagnosis and treatment of DKD |
Figure 2 Quality of the included guidelines for the six domains of the AGREE Ⅱ instrument A-F: scaled-domain percentage quality assessment results. A: domain 1 percentage quality assessment results; B: domain 2 percentage quality assessment results; C: domain 3 percentage quality assessment results; D: domain 4 percentage quality assessment results; E: domain 5 percentage quality assessment results; F: domain 6 percentage quality assessment results. DSCACM: Diabetes Society of China Association of Chinese Medicine; PCEM: Professional Committee of Endocrinology and Metabolism, Traditional Chinese and Western Medicine Doctor Branch, Chinese Medical Doctor Association; MCGCDS: Microvascular Complications Group of Chinese Diabetes Society; DKDCG: Diabetic Kidney Disease Cooperative Group of Peking University Health Science Center; CSE: Chinese Society of Endocrinology; CSN: Chinese Society of Nephrology. CSNa 2021: Chinese guidelines for diagnosis and treatment of diabetic kidney disease. CSNb 2022: Expert consensus on Diagnosis, Prognosis Assessment and Application of Biomarkers in Diabetic Kidney Disease; CSNc 2022: Chinese Guidelines for Renal Replacement Therapy in Diabetic End-stage Renal Disease. CSGP: Chinese Society of General Practice, Writing Group of Guideline for Primary Care of Diabetes Kidney Disease in China; ADA: American Diabetes Association.
Name | Scope and purpose | Stakeholder involvement | Rigour of development | Clarity of presentation | Application | Editorial independence | Mean | Recommended for use | |
---|---|---|---|---|---|---|---|---|---|
DSCACM 201119 | 63 | 47 | 16 | 64 | 24 | 17 | 39 | Not recommended | |
PCEM 202220 | 53 | 58 | 32 | 68 | 24 | 17 | 42 | Recommended with modifications | |
MCGCDS 202121 | 79 | 54 | 47 | 86 | 53 | 67 | 64 | Recommended | |
CSE 201522 | 79 | 39 | 29 | 65 | 35 | 17 | 44 | Not recommended | |
Jiang SM et al 202023 | 78 | 40 | 24 | 60 | 23 | 50 | 46 | Not recommended | |
DKDCG 202024 | 90 | 61 | 55 | 78 | 58 | 96 | 73 | Recommended | |
Zhang JQ et al 202125 | 78 | 43 | 26 | 76 | 35 | 96 | 59 | Recommended with modifications | |
CSNa 202126 | 89 | 58 | 38 | 83 | 54 | 67 | 65 | Recommended | |
CSNb 202227 | 96 | 60 | 29 | 96 | 43 | 67 | 65 | Recommended | |
CSNc 202228 | 79 | 75 | 20 | 72 | 35 | 69 | 58 | Recommended with modifications | |
Wang B et al 202229 | 99 | 65 | 77 | 53 | 41 | 96 | 72 | Recommended | |
CSE 202230 | 82 | 60 | 24 | 69 | 18 | 85 | 56 | Recommended, with modifications | |
CSGP 202331 | 96 | 68 | 31 | 93 | 25 | 96 | 68 | Recommended | |
Souriji H et al 201932 | 65 | 33 | 24 | 81 | 36 | 88 | 55 | Not recommended | |
Liew A et al 202033 | 74 | 33 | 34 | 86 | 45 | 10 | 47 | Recommended with modifications | |
Pugliese G et al, 201934 | 57 | 26 | 24 | 74 | 29 | 96 | 51 | Not recommended | |
Mean | 79 | 51 | 33 | 75 | 36 | 65 | / | / |
Table 2 Scaled domain percentage quality and overall assessments for each CPG (%)
Name | Scope and purpose | Stakeholder involvement | Rigour of development | Clarity of presentation | Application | Editorial independence | Mean | Recommended for use | |
---|---|---|---|---|---|---|---|---|---|
DSCACM 201119 | 63 | 47 | 16 | 64 | 24 | 17 | 39 | Not recommended | |
PCEM 202220 | 53 | 58 | 32 | 68 | 24 | 17 | 42 | Recommended with modifications | |
MCGCDS 202121 | 79 | 54 | 47 | 86 | 53 | 67 | 64 | Recommended | |
CSE 201522 | 79 | 39 | 29 | 65 | 35 | 17 | 44 | Not recommended | |
Jiang SM et al 202023 | 78 | 40 | 24 | 60 | 23 | 50 | 46 | Not recommended | |
DKDCG 202024 | 90 | 61 | 55 | 78 | 58 | 96 | 73 | Recommended | |
Zhang JQ et al 202125 | 78 | 43 | 26 | 76 | 35 | 96 | 59 | Recommended with modifications | |
CSNa 202126 | 89 | 58 | 38 | 83 | 54 | 67 | 65 | Recommended | |
CSNb 202227 | 96 | 60 | 29 | 96 | 43 | 67 | 65 | Recommended | |
CSNc 202228 | 79 | 75 | 20 | 72 | 35 | 69 | 58 | Recommended with modifications | |
Wang B et al 202229 | 99 | 65 | 77 | 53 | 41 | 96 | 72 | Recommended | |
CSE 202230 | 82 | 60 | 24 | 69 | 18 | 85 | 56 | Recommended, with modifications | |
CSGP 202331 | 96 | 68 | 31 | 93 | 25 | 96 | 68 | Recommended | |
Souriji H et al 201932 | 65 | 33 | 24 | 81 | 36 | 88 | 55 | Not recommended | |
Liew A et al 202033 | 74 | 33 | 34 | 86 | 45 | 10 | 47 | Recommended with modifications | |
Pugliese G et al, 201934 | 57 | 26 | 24 | 74 | 29 | 96 | 51 | Not recommended | |
Mean | 79 | 51 | 33 | 75 | 36 | 65 | / | / |
Domain | ICC | Confidence interval (95%) |
---|---|---|
Scope and purpose | 0.90 | (0.80, 0.96) |
Stakeholder involvement | 0.89 | (0.78, 0.95) |
Rigour of development | 0.97 | (0.93, 0.99) |
Clarity of presentation | 0.84 | (0.69, 0.93) |
Application | 0.88 | (0.77, 0.95) |
Editorial independence | 0.99 | (0.981, 0.997) |
Overall rating | 0.90 | (0.81, 0.96) |
Table 3 Inter-rater agreement for AGREE Ⅱ domains
Domain | ICC | Confidence interval (95%) |
---|---|---|
Scope and purpose | 0.90 | (0.80, 0.96) |
Stakeholder involvement | 0.89 | (0.78, 0.95) |
Rigour of development | 0.97 | (0.93, 0.99) |
Clarity of presentation | 0.84 | (0.69, 0.93) |
Application | 0.88 | (0.77, 0.95) |
Editorial independence | 0.99 | (0.981, 0.997) |
Overall rating | 0.90 | (0.81, 0.96) |
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