Influence of industry on renal guideline development.

T here is ongoing controversy concerning the influence of the pharmaceutical industry on physicians, research publications, medical societies, and disease advocacy groups (1–7). Nowhere is the potential influence of industry more concerning than in development of clinical practice guidelines (8), which are designed to improve and standardize patient care yet also have enormous economic implications. As outlined herein, industry has provided major financial support to the National Kidney Foundation (NKF), the principal organization that develops and promulgates management guidelines in nephrology, and honoraria and/or research support to many participants who are involved in nephrology guideline development. Opinion-based recommendations have benefited some industries and harmed others. If not managed appropriately, then these relationships have the opportunity to undermine the guidelines and harm industry’s reputation. They also may reflect poorly on the renal community in general and threaten our independence. Major changes are necessary to limit the influence of conflicts of interest and the appearance of undue influence. The recent 2006 Kidney and Dialysis Outcomes Quality Initiative (KDOQI) anemia guidelines highlight many of these issues.