A Chinese Multi-Specialty Delphi Consensus to Optimize RAASi Usage and Hyperkalaemia Management in Patients with Chronic Kidney Disease and Heart Failure  

作　　者：Ming-Hui Zhao Wei Chen Hong Cheng Bi-Cheng Liu Zhi-Guo Mao Zhuang Tian Gang Xu Jing-Min Zhou 

机构地区：[1]Renal Division,Peking University First Hospital,Beijing 100034,China [2]Department of Nephrology,The First Affiliated Hospital,Sun Yat-Sen University,Guangzhou 510080,China [3]Department of Nephrology,Capital Medical University,Beijing 100029,China [4]Department of Nephrology,Southeast University Zhongda Hospital,Nanjing 210009,China [5]Department of Nephrology,Shanghai Changzheng Hospital,Shanghai 200003,China [6]Department of Cardiology,Peking Union Medical College Hospital,Beijing 100730,China [7]Renal Division,Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430030,China [8]Department of Cardiology,Zhongshan Hospital,Fudan University,Shanghai 200032,China

出　　处：《Chinese Medical Sciences Journal》2024年第2期79-90,共12页中国医学科学杂志（英文版）

摘　　要：Objective Variations are present in common clinical practices regarding best practice in managing hyperkalaemia(HK),there is therefore a need to establish a multi-specialty approach to optimal renin angiotension-aldosterone system inhibitors(RAASi)usage and HK management in patients with chronic kidney disease(CKD)&heart failure(HF).This study aimed to establish a multi-speciality approach to the optimal use of RAASi and the management of HK in patients with CKD and HF.Methods A steering expert group of cardiology and nephrology experts across China were convened to discuss challenges to HK management through a nominal group technique.The group then created a list of 41 statements for a consensus questionnaire,which was distributed for a further survey in extended panel group of cardiologists and nephrologists across China.Consensus was assessed using a modified Delphi technique,with agreement defined as"strong"(≥75%and<90%)and"very strong"(≥90%).The steering group,data collection,and analysis were aided by an independent facilitator.Results A total of 150 responses from 21 provinces across China were recruited in the survey.Respondents were comprised of an even split(n=75,50%)between cardiologists and nephrologists.All 41 statements achieved the 75%consensus agreement threshold,of which 27 statements attained very strong consensus(≥90%agreement)and 14 attained strong consensus(agreement between 75%and 90%).Conclusion Based on the agreement levels from respondents,the steering group agreed a set of recommendations intended to improve patient outcomes in the use of RAASi therapy and HK management in China.

关 键 词：Sardiorenal syndrome chronic kidney failure heart failure HYPERKALEMIA multidisciplinary communication RAASi 

分 类 号：R692[医药卫生—泌尿科学] R541.6[医药卫生—外科学]