NICE COVID-19 rapid guidelines

COVID-19 rapid reviews of interest to Specialised commissioning
NICE 
Check NICE website for new guidelines and updates

• COVID-19 rapid guideline: haematopoietic stem cell transplantation (NG164) 1 April 2020 Updated 10 February 2021
• COVID-19 rapid guideline: delivery of systemic anticancer treatments (NG161) 20 March 2020 Updated 12 February 2021
• COVID-19 rapid guideline: dialysis service delivery (NG160) updated 11 September 2020
• COVID-19 rapid guideline: critical care in adults (NG159) updated: 12 February 2021
• COVID 19 rapid guideline: renal transplantation (NG178) 19 June 2020 updated 19 August 2020
• COVID-19 rapid guideline: arranging planned care in hospitals and diagnostic services
  NICE guideline [NG179] 27 July 2020
  
  • The purpose of this guideline is to help healthcare professionals deliver efficient planned care while minimising the risk of COVID-19 in the context of increasing or decreasing local prevalence. It also aims to help patients make decisions about their planned care. It is for adults, young people and children in hospitals and diagnostic settings.
• COVID-19 rapid guideline: delivery of radiotherapy (NG162) 28 March 2020 updated 12 february 2021
• COVID-19 rapid guideline: cystic fibrosis (NG170) 09 April 2020 updated 7 October 2020
• COVID-19 rapid guideline: interstitial lung disease (NG177) 15 May 2020

The prevalence of frailty in patients on hemodialysis

The prevalence of frailty in patients on hemodialysis: a systematic review and meta-analysis.

Int Urol Nephrol. 2020 Jan;52(1):115-120. doi: 10.1007/s11255-019-02310-2

• A review of the evidence concludes that frailty influences almost three in ten patients on hemodialysis. 

Abstract

The prevalence of frailty in patients on hemodialysis: a systematic review and meta-analysis.

The prevalence of frailty in patients on hemodialysis: a systematic review and meta-analysis.
Int Urol Nephrol. 2019 Oct 23. doi: 10.1007/s11255-019-02310-2.

• Analysis of data from the international literature concludes that prevalence frailty influences almost three in ten patients on haemodialysis. There were no significant relationships between frailty in haemodialysis and factors such as country (Europe & USA vs Asia) or duration of haemodialysis.

Abstract

Establishing a tele-clinic service for kidney transplant recipients through a patient-codesigned quality improvement project

Establishing a tele-clinic service for kidney transplant recipients through a patient-codesigned quality improvement project.
BMJ Open Qual 2019;8:e000427. 8 April 2019. doi: 10.1136/bmjoq-2018-000427

• Findings from a pilot tele-clinic (telephone consultation) service for kidney transplant patients attending North Bristol NHS Trust Renal Unit shows that they are deliverable and well received by patients with a positive environmental impact and modest financial savings. 
• "It has the potential to be rolled out to other renal centres if a national tele-clinic tariff can be negotiated, and an integrated, appropriately reimbursed community phlebotomy system can be developed to facilitate remote monitoring of patients."

Abstract

Improving the care of patients living with Chronic Kidney Disease

Improving the care of patients living with Chronic Kidney Disease
North London Partners’ 7 February 2019

• A virtual healthcare model to improve the care of patients living with chronic kidney disease through provision of an integrated service between primary and specialist care, reducing waiting times and unnecessary hospital visits. Consultants can access patients’ GP records in real time to provide GPs with advice and guidance and a written comprehensive care management plan.
• See also Development and evaluation of a renal learning health system across inner east London, Health Foundation December 2018

Development and evaluation of a renal learning health system across inner east London

Development and evaluation of a renal learning health system across inner east London
Health Foundation December 2018

• The east London community kidney service was conceived as a renal learning health system, extending across primary and secondary care, with data providing feedback to improve the delivery of care and clinical performance.
• The two innovative components include:
• A virtual CKD clinic, in which nephrologists can see the entire GP patient record (with consent) and enter management suggestions.
• A suite of IT tools for practices to improve identification and management of CKD. A novel ‘trigger tool’ alerts GPs to cases of possible CKD progression.
• Major impacts include: 
• A reduction in wait time for a specialist opinion from 64 to 5-10 days 
• Only 20% of patients referred to the virtual clinic require a hospital appointment 
• Significant improvements to GP identification and management of CKD. 
• Nurse led self-management education for patients 
• See also NHS ENgland case study New virtual clinic designed by doctors gives renal patients more specialist consultant time 

Kidney replacement Guidance and Quality Standard updates

Renal replacement therapy and conservative management [NG107]
NICE 3 October 2018

• This guideline covers renal replacement therapy (dialysis and transplantation) and conservative management for people with chronic kidney disease stages 4 and 5.
• Updates and replaces NICE guideline CG125 (July 2011) and NICE technology appraisal guidance 48 (September 2002).
• NICE press release.

Renal replacement therapy services for adults [QS72]

NICE Quality standard updated October 2018

• This quality standard was updated to reflect updated guidance (above) and covers renal replacement therapy services for adults with kidney failure. It includes treatment options, such as dialysis and kidney transplant.

Robot-assisted kidney transplant [IPG609]

Robot-assisted kidney transplant [IPG609]
NICE April 2018

• This Interventional Procedures Guidance (IPG) concludes that current evidence on the safety and efficacy of robot-assisted kidney transplant is limited in quantity and quality. It presents recommendations in relation to patients with obesity, and patients for whom open kidney transplant surgery is suitable. 
• The procedure should only be done by teams of surgeons with experience in both transplant surgery and robotic surgery.

Robot assisted laparoscopic partial nephrectomy (RALPN) in patients with T1a or T1b renal cancer

Robot assisted laparoscopic partial nephrectomy in patients with T1a or T1b renal cancer: evidence note 75
Healthcare Improvement Scotland 18 January 2018
Key points

Peritoneal dialysis for acute kidney injury.

Peritoneal dialysis for acute kidney injury.
Cochrane Database of Systematic Reviews 2017, Issue 12. Art. No.: CD011457

• Analysis of six studies (484 participants) concludes that there is currently not enough evidence to determine whether there are significant differences in death due to any cause or recovery of kidney function between patients treated with PD, extracorporeal therapies, or intensity of PD.