Canadian Society of Nephrology Commentary on the 2021 KDIGO Glomerulonephritis Guidelines and 2023 ANCA/Lupus Updates
Bibliographic record
Abstract
Background: The Canadian Society of Nephrology (CSN) completes commentary on published Kidney Disease Improving Global Outcomes (KDIGO) Guidelines. In 2021, KDIGO published Glomerulonephritis (GN) guidelines with recent 2023 guideline updates. KDIGO guidelines includes Recommendations and practice points (PP), which are used when there is insufficient evidence for a Recommendation. In this article we describe the process and highlight findings of the CSN commentary on the KDIGO GN guidelines. Methods: The CSN established a working group including adult and pediatric nephrologists, pharmacists, pediatricians, pathologists, and patient partners with expertise in GN across Canada. The working group aimed to review guideline’s relevance and applicability to the Canadian context when caring for patients with GN. Recommendations from the KDIGO 2021 GN guidelines (including 2023 lupus and ANCA updates) were assessed with a standardized survey assessing whether working group members agreed or not with the Recommendation with focus on highlighting specific Canadian context that may impact the recommendation. Recommendations attaining <80% consensus or those with comments pertaining to important considerations to the Canadian context were specifically discussed. Practice points were discussed amongst working group members and relevant PP were highlighted. Results: This commentary highlights the impact of the KDIGO GN guideline Recommendations and PP on GN care in Canada. In general, the CSN working group agrees with most of the guideline statements by KDIGO. This commentary highlights the uptake of certain PP including lack of evidence, practice variation, and areas of controversy. Health equity and virtual medical care were important issues impacting GN care in Canada. Conclusions: Canadian Society of Nephrology GN working group generally agrees with the KDIGO GN guidelines and recent lupus nephritis and ANCA updates, and highlights areas relevant to the Canadian healthcare for patients with GN. Funding: Government Support - Non-U.S.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.019 | 0.115 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.003 | 0.004 |
| Science and technology studies | 0.011 | 0.009 |
| Scholarly communication | 0.010 | 0.003 |
| Open science | 0.006 | 0.004 |
| Research integrity | 0.024 | 0.023 |
| Insufficient payload (model declined to judge) | 0.023 | 0.007 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".