Why we need clinical practice guidelines in chronic kidney disease.
Clinical practice guidelines (CPGs) have become an essential, useful, and integral part of the practice of medicine in general and for the care of patients with chronic kidney disease (CKD) in particular. The reasons why CPGs have proven useful are related to the need of physicians, patients, and providers. Physician needs stem from the overwhelming amount of new information generated that requires systematic analysis, synthesis, and translation into specific clinically applicable recommendations. Patient needs arise from the desire of an increasingly well-informed public seeking evidence-based information in making joint decisions with their physicians. Provider needs derive from the necessity of appropriate criteria in assessing improved outcomes and in closing existing quality chasms in health care delivery. It is in the one patient one physician clinical encounter setting that guidelines are likely at their best in helping make appropriate decisions in each specific situation. All other uses of CPGs, no matter how meritorious, are secondary derivatives.