摘要目的 针对我国肾脏疾病临床实践指南进行评价,为遴选符合我国临床实际、高质量的肾脏疾病指南以及今后指南的规范化制定提供参考依据、提出改进建议.方法 利用计算机及手工检索中国临床指南文库、中国生物医学文献数据库、维普数据库、万方数据库和中国知网等,检索起止时间为2013年1月至2018年7月.按照既定纳入和排除标准筛选公开发表的国内肾脏疾病指南,按照中国临床实践指南评价体系系统分析和评价我国肾脏疾病指南现状.结果 共纳入18部国内肾脏疾病临床实践指南,涵盖肾小球肾炎、肾病综合征、终末期肾病等病种.总体得分范围为30～68分,平均得分为47.3分;在科学性/严谨性、有效性/安全性、经济性、可用性/可行性和利益冲突5个评价领域的平均得分分别为20.1分、12.8分、0.5分、9.9分和3.9分.其中,8部(44.4％)指南的整体印象评价为强推荐,10部(55.6％)指南为弱推荐.结论 我国肾脏疾病指南在科学性/严谨性、经济性等方面存在不足,与循证指南的要求存在一定差距.中国临床实践指南评价体系可作为符合我国国情的指南评价工具,但是其实用性和可行性仍需进一步验证和完善.

abstractsObjective To evaluate the quality of clinical practice guidelines for kidney diseases in China and provide reference for selecting suitable high-quality guidelines for primary care and developing standardized guidelines. Methods The China Guideline Clearinghouse, China Biology Medicine disc, VIP Database, Wanfang Database and CNKI, and other resources were searchedfrom January 2013 to July 2018. In accordance with the criteria for inclusion and exclusion, the published guidelines for kidney diseases were screened. The Appraisal of Guidelines Research and Evaluation-China (AGREE-China) was used to systematically assess the current status of domestic guidelines for kidney diseases. Results A total of 18 guidelines for kidney diseases were included, covering different types of kidney disease such as glomerulonephritis, nephrotic syndrome, end-stage renal disease and other diseases. The overall score ranged from 30 to 68, with an average score of 47.3. The average scores of these guidelines were 20.1, 12.8, 0.5, 9.9 and 3.9 in five review fields including scientificity/rigorism, effectiveness/safety, economy, availability/feasibility, and conflicts of interest, respectively. Of these 18 guidelines, 8(44.4％) guidelines were strongly recommended, and 10(55.6％) guidelines were weakly recommended. Conclusions There are still deficiencies in scientificity/rigorism and economy in current guidelines for kidney diseases in China. The AGREE-China can be used as an evaluation tool for guidelines for kidney diseases in accordance with China's situation, while its practicability and feasibility still need further verification and improvement.