目标:在管理高钾血症(香港)的最佳实践方面,常见的临床实践存在差异,因此,有必要建立一种多专业方法,以优化肾素-血管紧张素-醛固酮系统抑制剂(RAASi)的使用和慢性肾脏病(CKD)和心力衰竭(HF)患者的HK管理.本研究旨在建立一种多专业方法,以优化RAASi的使用以及如何管理CKD和HF患者的HK。方法:来自中国各地的心脏病学和肾脏病学专家指导专家组召开会议,讨论通过名义分组技术(NGT)对香港管理的挑战。然后,该小组为共识问卷创建了41个声明列表,在中国各地的心脏病学家和肾病学家的扩展小组中进行了进一步调查。共识使用改进的德尔菲技术进行评估,协议定义为“强”(≥75%和<90%)和“非常强”(≥90%)。指导小组,数据收集,和分析由独立的主持人协助。结果:共有来自中国21个省份的150份答复被纳入调查。受访者包括心脏病学家和肾病学家之间的平均分裂(n=75,50%)。所有41份声明都达到了75%的共识协议门槛,其中27项陈述达成了非常强烈的共识(≥90%的共识),14项陈述达成了强烈的共识(75%至90%的共识)。结论:根据受访者的协议水平,指导小组同意了一系列建议,旨在改善在中国使用RAASi治疗和HK管理的患者结局.
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.