Recommendations for research

As part of the 2021 update, the guideline committee made 18 research recommendations on chronic kidney disease. They prioritised 5 key research recommendations. They also retained some research recommendations from previous guidelines.

Key recommendations for research

1 Creatinine-based estimate of eGFR – existing calculations

In adults, children and young people from black, Asian and other minority ethnic groups with chronic kidney disease (CKD) living in the UK, which existing eGFR calculations are the most accurate? [2021]

2 Creatinine-based estimate of eGFR – improving accuracy of calculations

In adults, children and young people from black, Asian and other minority ethnic groups with CKD living in the UK, what biomarkers or factors, other than ethnicity, improve the diagnostic accuracy of eGFR calculations? [2021]

For a short explanation of why the committee made these recommendations for research, see the rationale on creatinine-based estimate of GFR.

Full details of the evidence and the committee's discussion are in evidence review A: diagnostic accuracy of eGFR calculations in adults, children, and young people from black, Asian and other minority ethnic groups with CKD.

3 Risk assessment for black, Asian and minority ethnic groups

What is the accuracy of the 4-variable Kidney Failure Risk Equation in adults, children and young people with CKD from black, Asian and minority ethnic groups living in the UK? [2021]

For a short explanation of why the committee made this recommendation for research, see the rationale on risk assessment, referral criteria and shared care.

Full details of the evidence and the committee's discussion are in evidence review F: the best combination of measures to identify increased risk of progression in adults, children and young people.

4 Managing anaemia – optimal Hb levels for children and young people

What is the efficacy and safety of different aspirational haemoglobin (Hb) targets for children and young people with CKD undergoing treatment for anaemia? [2021]

For a short explanation of why the committee made this recommendation for research, see the rationale on optimal Hb levels.

Full details of the evidence and the committee's discussion are in evidence review J: aspirational haemoglobin target range for children and young people with CKD.

5 Hyperphosphatemia in people with CKD stage 4 or 5

What are people with CKD and their family members and carers views and beliefs about taking oral phosphate binders? [2021]

For a short explanation of why the committee made this recommendation for research, see the rationale on hyperphosphataemia in people with CKD stage 4 or 5.

Full details of the evidence and the committee's discussion are in evidence review L: use of phosphate binders.

Other recommendations for research

Cystatin-C equations

What is the diagnostic accuracy of cystatin-C equations to estimate GFR as a measurement of kidney function in adults, young people and children in the UK? [2021]

Investigations for proteinuria

In children and young people, what is the accuracy of reagent strips for detecting albumin in urine? [2021]

What is the effect of measuring proteinuria with albumin:creatinine ratio compared with protein:creatinine ratio on the timing of treatment changes in children and young people with CKD? [2021]

Frequency of monitoring

For adults, children and young people with CKD, what is the optimal monitoring frequency for albumin:creatinine ratio? [2021]

Risk assessment, referral criteria and shared care

What is the association between risk factors and CKD outcomes in children and young people? [2021]

What is the accuracy of the 4-variable Kidney Failure Risk Equation in children and young people living in the UK? [2021]

Frequency of review

What is the most clinical and cost-effective frequency of review for children and young people with CKD? [2021]

Managing anaemia

For adults, children and young people with CKD and anaemia, what is the diagnostic accuracy of eGFR thresholds of 60, 45, and 30 ml/min/1.73 m2 for determining whether the anaemia is due to CKD? [2021]

For adults, children and young people with CKD and anaemia who are on peritoneal dialysis, what amount of intravenous (IV) iron is most clinically and cost effective in managing anaemia and its associated outcomes (including quality of life)? [2021]

What are the long-term consequences of high ferritin levels (above 800 micrograms/litre) in children and young people with CKD? [2021]

Phosphate binders

Which binders are the most clinically and cost effective in controlling serum phosphate in adults, children and young people with stage 4 or 5 CKD who are not on dialysis? [2021]

In adults with stage 4 or 5 CKD, including those on dialysis, what is the clinical and cost effectiveness and safety of long-term calcium acetate combined with magnesium carbonate for controlling serum phosphate? [2021]

Self-management of CKD

Does the provision of educational and supportive interventions to people with CKD by healthcare professionals increase the person's skills and confidence in managing their conditions and improve clinical outcomes? [2014]

Antiplatelet therapy

For people with CKD at the highest risk of cardiovascular disease, what is the clinical effectiveness of low-dose aspirin compared with placebo for primary prevention of cardiovascular disease? [2014]

Renin–angiotensin–aldosterone system antagonists

For people aged over 75 years with CKD, what is the clinical effectiveness of renin–angiotensin–aldosterone system (RAAS) antagonists? [2014]

Vitamin D supplements in the management of CKD–mineral and bone disorders

In people with hyperparathyroidism secondary to CKD, does treatment with vitamin D or vitamin D analogues improve patient-related outcomes? [2014]

Management of anaemia of CKD with concurrent illness

What is the optimal management (in terms of clinical and cost effectiveness) of anaemia of CKD in people who are receiving erythropoietic stimulating agents (ESAs) and have a significant concurrent acute infectious illness? [2015]

Treatment of ESA resistance in people on haemodialysis

What is the most effective type of intervention to treat people on haemodialysis with ESA‑resistant anaemia? [2015]

  • National Institute for Health and Care Excellence (NICE)