Nephrol Dial Transplant 2006;21:3127C32. and it uses a description of medical questions (CQs) according to the policy of publication for the medical practice guidelines of the Medical Info Network Distribution Services (MINDS). In 2012, an international guideline 2-Aminoethyl-mono-amide-DOTA-tris(tBu ester) for glomerulonephritis, including NS, the Guideline for Glomerulonephritis, was published from the Kidney Disease Improving Global End result (KDIGO). Therefore, the operating group of the third NS guideline examined the material of the KDIGO guideline as an important research and re-evaluated Japanese treatment strategy in the past and the material of earlier guidelines already published in our country. We attempted that the third clinical guideline was considered to be appropriate for recent clinical methods for NS in Japan. 2. The Intended Purpose, Anticipated Users, and Expected Social Significance of the Guidelines The third NS guideline is intended like a research for physicians engaging in the treatment of individuals with NS. Practical medical info on NS was included in this guideline for both professionals and nonspecialists of nephrology. We described essential knowledge concerning NS in the 1st part and proposed many CQs associated with treatment in the later on part. The response to each query was written as a statement with a recommendation grade. In the last part, we proposed a summary of a treatment strategy. In this summarized strategy, we proposed new treatment ideas based on previous ideas. The new strategy with algorithm figures may be helpful for the decision for treatment by physicians seeing nephrotic patients. We found only limited articles around the treatments of adults with NS. The number of subjective patients was small in these articles. Therefore, the strategy resolved in this guideline did not completely pressure physicians to follow the stereotyped protocol, but rather we expected that our strategy would be helpful in decision making for the treatment of an individual patient with NS. Because Sirt7 aging patients with NS having numerous complications are increasing, the individual decision for the treatment of each individual is also necessary. We want to strongly insist that this guideline is not a decision basis for medical malpractice lawsuits or trials. 3. Patients within the scope of the guidelines This guideline is intended as a reference for the treatment of patients with main NS. In the preparation process of the guideline, we used evidence articles of pediatric patients if we could not find evidence articles of adult patients. In a part of the guideline, we referred to non-nephrotic cases. Recurrent NS occurring after kidney transplantation and NS associated with pregnancy were excluded from this guideline. For pregnant cases with NS, we hope that you refer to the Clinical Guideline for Pregnancy of Kidney Disease Patients that was edited by the JSN. 4. Preparation procedure At first, we collected evidence articles available for guideline preparation. The working group of the NS guideline was set up. Nephrologists with sufficient knowledge and experience voluntarily participated in this working group. On September 9, 2011, a progressive kidney disease research group supported by the MHLW research foundation, which functions to control refractory disease, opened the first collaborative meeting concerning 4 major nephrology diseases, including IgAN, NS, rapidly progressive glomerulonephritis, and polycystic kidney disease. Dr. Tsuguya Fukui, the president of St. Lukes International Hospital, was invited as an adviser of this meeting. The users of the 4 working groups of the guideline 2-Aminoethyl-mono-amide-DOTA-tris(tBu ester) learned the significant meaning of the guideline and the procedures for guideline preparation from his lecture. Thereafter, we began to write our guideline using common concepts. Consequently, our working group of the NS guideline determined CQs with the Delphi method and free cross-talk communication. The survey of reference articles was performed using the PubMed database. For a basic survey, evidence articles were collected from already published papers until July 2012, and important articles were selected on demand from papers published after July 2012. Through several working group meetings and E-mail discussions, our working group 2-Aminoethyl-mono-amide-DOTA-tris(tBu ester) summarized the contents of the NS guideline. In addition, several collaborative meetings concerning the 4 major kidney 2-Aminoethyl-mono-amide-DOTA-tris(tBu ester) diseases, IgAN, NS, rapidly progressive glomerulonephritis, and polycystic kidney disease, were opened. In these meetings, the first CQs were properly revised. From August 2013 to October 2013, our working group asked for a review of the guideline by designated reviewers belonging to related academic societies. At the.
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