Denise Campbell

Consumer involvement in topic and outcome selection in the development of clinical practice guidelines.

Background  Consumer involvement in guideline development is advocated, but minimal participation, such as a nominated consumer representative on a guideline working group, can inhibit their decision‐making power and contribution. Little is known about how to involve consumers more effectively in guideline development.

Assessment of kidney function in type 2 diabetes

Date written: April 2009

Prevention and management of chronic kidney disease in type 2 diabetes

Date written: April 2009

Prevention of peritoneal dialysis-related infections

The use of peritoneal dialysis (PD) varies widely from country to country, with the main limitation being infectious complications, particularly peritonitis, which leads to technique failure, hospitalization and increased mortality. A large number of prophylactic strategies have been employed to reduce the occurrence of peritonitis, including the use of oral, nasal and topical antibiotics, disinfection of the exit site, modification of the transfer set used in continuous ambulatory PD exchanges, changes to the design of the PD catheter implanted, the surgical method by which the PD catheter is inserted, the type and length of training given to patients, the occurrence of home visits by trained PD nurses, the use of antibiotic prophylaxis in patients undergoing certain invasive procedures and the administration of antifungal prophylaxis to PD patients whenever they are given an antibiotic treatment course. This review summarizes the existing evidence evaluating these interventions to prevent exit-site/tunnel infections and peritonitis.

Cost-effectiveness and socioeconomic implications of prevention and management of chronic kidney disease in type 2 diabetes

Microalbuminuria is an asymptomatic condition that affects 20–40% of people with type 2 diabetes. Of these, only about 20% are normotensive by current criteria. The rate of progression of microalbuminuria is slower in normotensive than in hypertensive people. Its significance arises from the proportion of affected people (40–80%) who subsequently develop either cardiovascular disease (CVD) or who develop proteinuria with eventual progression to renal failure. ESKD causes a significant decline in quality of life, is expensive, and is associated with considerable mortality – approximately 15 per 100 patient years of Australians undergoing dialysis die annually. Based on a review of clinical trials a risk multiplier of 3.29 was estimated for mortality in people with type 2 diabetes, elevated blood pressure (BP) and overt nephropathy compared with those with no nephropathy. In the Australian health sector, costs for provision of ESKD health care services has been projected to increase in the order of

Commentary on “Influence of Industry on Renal Guideline Development”

A50M per year and reach more than

Identifying and integrating patient and caregiver perspectives for clinical practice guidelines on the screening and management of infectious microorganisms in hemodialysis units

A800M by 2010. This reflects the increasing prevalence of dialysis dependent patients and costs in the order of

Infection prophylaxis in peritoneal dialysis patients: results from an Australia/New Zealand survey

A40 000 to

Assessment of Current Practice and Barriers to Antimicrobial Prophylaxis in Peritoneal Dialysis Patients

A45 000 per person per year. These ESKD cost projections exclude the costs associated with co-morbid conditions such as CVD as well as indirect or non-health sector costs associated with ESKD. Similarly, in the USA, O’Brien et al. highlighted that the direct costs arising from ESKD were the most expensive of 15 different complications of type 2 diabetes. ESKD in the USA costs

Antimicrobial agents for preventing peritonitis in peritoneal dialysis patients

53 659 per annum per patient. In comparison, ischaemic stroke has an event cost of