Overview

The major purpose of the CPG Committee of the CSN is to develop CPGs or Clinical Practice Recommendations for CSN members. The overriding goal is to improve the delivery of health care to kidney disease patients in Canada.

Clinical practice guidelines (CPG) are systematically developed statements to assist practitioners and patients reach appropriate health care decisions. Their purpose is "to make explicit recommendations with a definite intent to influence what clinicians do." If developed properly, CPG assimilate and translate the abundance of evidence published on a daily basis into practice guidelines or recommendations.

In doing so, CPGs aim to reduce the use of unnecessary or harmful interventions, and facilitate the treatment of patients to achieve maximum benefit and minimum risk at an acceptable cost. CPGs are not meant to replace sound medical decision making which takes into account critical elements relevant to patient care including patient preferences and clinician experience.

Initiatives

Project/GuidelineChair(s)Details
2026 KDIGO Glomerular Disease Guideline Commentary (Download PDF)Arenn Jauhal
Michelle Hladunewich		Nov '25: Meetings have concluded. Manuscripts for both adult and pediatric guidelines are developed. Publications will be forthcoming.
Aug '25:
Have completed bulk of work – final revisions to each chapter underway​
Adult and Pediatrics manuscripts underway.
2025 KDIGO ADPKD Guideline CommentaryAhsan Alam
Matt Lanktree		Nov '25: Chapter specific meetings are finishing, with aim to complete publication Q4 2025.
Aug '25:
Have held initial meeting, distributed chapters, and are having chapter specific meetings currently and just about ready for presentation to larger group.​
Aim for publication to be submitted Q4 2025.
2025 KDIGO Anemia CommentaryMark Canney
David Collister		Nov '25: Chapter specific meetings are finishing, with aim to complete publication Q4 2025.
Aug '25:
First meeting April 2025; chapter meetings April 2025, followed by group meeting at CSN AGM​.
Chapter meetings and manuscript development for June meeting​.
Submission of manuscript for publication Q4 2025​.
Conservative Kidney Management GuidelineSara Davison
Reem Mustafa		Nov '25: Systematic reviews completed, with aim to complete publications in Q1 2026. Guideline panel convening Fall 2025.
Aug '25: Currently in phase 1 of 3 (nutrition-related complications) – systematic reviews nearing completion. Target completion of manuscripts Fall 2025. Guideline panelists are convening in early September to review results and form recommendations.
Peritoneal Dialysis Catheter Insertion GuidelineDavid Clark
Arsh Jain		Nov '25: Consensus of best practices for nephrologist inserted PD catheters has manuscript completed, awaiting submission. Guideline development phase underway. Plans for panelist meeting in 2026.
Aug '25:

Phase 2 of 3 – this phase done mid 2025 (this is the guideline development phase). Will publish consensus document for best practices in early 2025.

Phase 1 – Consensus from Canadian experts for PD catheter insertion – manuscript being circulated​

​Phase 2 – de novo guideline for PD catheter insertion by nephrologists. 5 PICO questions – evidence being synthesized. Aim for completion end 2025.​

​Phase 3 – Expert panel review of findings and writing of guideline – in 2026​
Choosing WiselyLisa MillerUpdate, Nov '25: Nephrology recommendations updated. Four new recommendations, accompanying the five existing recommendations, now published at https://choosingwiselycanada.org/recommendation/nephrology/. Manuscript describing development aimed for publication in Q1 2026.
Update, Aug '25:

Recommendations developed from Canadian kidney societies survey responses and other Choosing Wisely organizations, (131 suggestions), which were then ranked based on importance, evidence for use, feasibility, potential for harm, frequency of use, and global importance. Narrowed down to 4 NEW recommendations, to accompany the 5 existing recommendations.

 Next steps:  Resubmission to CSN Officers, free communications, manuscript preparation.  Also working with SNAP to include a nephrology recommendation in the Choosing Wisely Climate Action recommendations.

Library/Guidelines

Download the 2026 KDIGO Glomerular Disease Guideline Commentary (PDF)

METHODS & INITIATIVES

CKD

PERITONEAL DIALYSIS

HEMODIALYSIS

ANEMIA

TRANSPLANT

KDIGO GUIDELINES

Endorsements

Name of the guideline:  Nursing Recommendations for the Management of Vascular Access in Adult Hemodialysis Patients 2023 Update

Consensus statements and clinical practice guidelines provide guidance to clinicians. Both documents provide recommendations for optimizing patient care, but there are important differences between them. A clinical practice guideline produces recommendation informed by a methodologic framework, systematic review of the evidence and a transparent assessment of the benefits and harms of alternative options. A consensus statement is developed by an independent panel of experts, usually multidisciplinary, convened to review the research literature in an evidence-based manner for the purpose of advancing the understanding of an issue, procedure or method (provide ref here).
 
The Nursing Recommendations for the Management of Vascular Access in Adult Hemodialysis Patients 2023 Update, produced by the CANNT, was reviewed for CSN endorsement independently by 2 members of the CSN CPGC. The recommendations have great relevance and importance to the Canadian Nephrology community and are presented clearly with examples to demonstrate applicability. A panel of experts was convened who reviewed available evidence on this topic without a standardized and published methodologic framework.


The CSN is pleased to endorse the  2023 Update to the Nursing Recommendations for the Management of Vascular Access in Adult Hemodialysis Patients as a Consensus Statement

Type: Endorsement as a Consensus Statement.

Endorsement Date:  November 2024

Name of the guideline: Recommendations for Genetic Testing and Eligibility Criteria 

Consensus statements and clinical practice guidelines provide guidance to clinicians. Both documents provide recommendations for optimizing patient care1, but there are important differences between them. A clinical practice guideline produces recommendation informed by a methodologic framework, systematic review of the evidence and a transparent assessment of the benefits and harms of alternative options. A consensus statement is developed by an independent panel of experts, usually multidisciplinary, convened to review the research literature in an evidence-based manner for the purpose of advancing the understanding of an issue, procedure or method.  

The CSN CPG Committee reviewed the Ontario Health mandated Provincial Genetics Program (PGP) document entitled “Recommendations for Genetic Testing and Eligibility Criteria” for endorsement. Independent review and subsequent summary recommendation was completed in duplicate by CSN CPGC members, and reviewed with CSN CPGC chair and vice chair. The document is developed for implementation in Ontario, though the recommendations do apply and could be adapted to other Canadian jurisdictions. Though not described in the document, the working group did have to disclose all potential or actual conflicts in alignment with Ontario Health’s policies. Importantly, there were no formal GRADE or structured framework used to develop recommendations. However, as we are evaluating this as a consensus statement and not a clinical practice guideline, this is acceptable.

 

Given the importance of this topic and how relevant it is to jurisdictions across Canada, we (the CSN) are supportive of this document and endorse it as a consensus statement.  

Type: Endorsement as a Consensus Statement.

Endorsement Date:  September 2025

 

Accompanying resources of interest:

Committee Members

HARRISON_Tyrone

Tyrone
Harrison

Chair, CPG Committee

Dr. Tyrone Harrison
Chair, Clinical Practice Guidelines Committee

Dr Tyrone Harrison MD PhD is an assistant professor of Medicine at the University of Calgary, where he works as a health services researcher and nephrologist. His current research program is mainly focused on integrating person-centredness within risk prediction strategies and population-based cohort studies for people with chronic diseases. His work is funded by the Kidney Foundation of Canada, and he is currently supported by a KRESCENT New Investigator Award (2023-2026). He is the current Chair of the CSN clinical practice guidelines committee. As part of the guidelines committee work, he has interest in incorporating the perspectives of people with lived experience and other stakeholders in determining committee priorities.

Dr. Harrison's Bio
MILLER_Lisa_

Lisa
Miller

Vice-Chair, CPG Committee

Dr. Lisa Miller

Dr. Lisa Miller received her MD at Memorial University of NL, then completed her internal medicine and nephrology training at Queens’s University.  She is currently an Assistant Professor at the University of Manitoba, a clinical nephrologist with Shared Health Manitoba, and is the Medical Director of the Sherbrook Dialysis Unit. She is a past board member of the Canadian Society of Nephrology, and is the Vice Chair of the Canadian Society of Nephrology Clinical Practice Guidelines Committee.  Dr. Miller chaired the Choosing Wisely Canada Nephrology working group, recently updating their recommendations and she is a core member of the National Conservative Kidney Management Committee.  

Dr. Miller’s clinical and research interests include vascular access, conservative kidney management, and quality improvement in chronic kidney disease and hemodialysis.  She also completed healthcare leadership training through University of Toronto and Harvard medical director institute, and is currently enrolled in the Harvard University’s Safety, Quality Improvement, Informatics, Leadership program.

Dr. Miller's BIO
pic_Alam

Ahsan
Alam

Dr. Ahsan Alam

Dr. Ahsan Alam is an Associate Professor of Medicine at McGill University. He is a staff nephrologist and transplant nephrologist  with the multiorgan transplant program at the McGill University Health Centre (MUHC). He holds a Master's degree in Clinical Research from Tufts University in Boston and is a member of the Research Institute of the MUHC. Dr. Alam is involved in several clinical research studies and educational initiatives related to autosomal dominant polycystic kidney disease and is also a medical director of the living donor transplant program at the MUHC.

Dr. Alam's Bio
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Rahul
Chanchlani

Dr. Rahul Chanchlani

Dr. Rahul Chanchlani is a pediatric nephrologist, clinician-researcher, and epidemiologist at McMaster University, Canada, where he serves as an Associate Professor of Pediatrics and a staff nephrologist at McMaster Children’s Hospital. He is also a Scientist at ICES and the Population Health Research Institute.

His research focuses on childhood hypertension as a modifiable risk factor for cardiovascular and kidney disease, including its epidemiology, risk factors, and strategies for early detection and intervention. His research has attracted more than $6.5 million in funding and resulted in over 120 peer-reviewed publications.

A dedicated mentor and collaborator, Dr. Chanchlani co-leads the 2026 Hypertension Canada Pediatric Hypertension Guidelines and collaborates with the World Health Organization on an international pediatric hypertension consortium. His contributions have been recognized with the IPNA Renée Habib Young Investigator Award, the 2025 Hypertension Canada Jacques de Champlain New Investigator Award, and McMaster University’s 2025 Faculty Mentor Award. He was selected for the International Society of Nephrology’s Emerging Leaders Program, serves as Deputy Chair of its Clinical Research Committee, and has been elected President of the Canadian Association of Pediatric Nephrologists for 2027–2029. He is also an Associate Editor for Kidney360 journal.

Dr. Chanchlani's Bio
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David
Clark

Dr. David Clark

Dr. David Clark is a nephrologist and Associate Professor of Medicine at Dalhousie University in Halifax, Nova Scotia. He received his MD at the University of Ottawa and completed Internal Medicine and Nephrology residency training at Dalhousie University as well as a clinical fellowship in Home Dialysis and MSc of Clinical Epidemiology and Biostatistics at Western University. He is the current Medical Lead for the Halifax Home Dialysis & Percutaneous Peritoneal Dialysis Catheter Insertion Programs, as well as the Program Director for the Home Dialysis Fellowship Training Program. He conducts clinical research within his interest areas of home dialysis & interventional nephrology and is an active member of the Kidney Research Institute of Nova Scotia.

Dr. Clark's Bio
HUNDEMER_Gregory

Gregory
Hundemer

Dr. Gregory Hundemer

Dr. Hundemer is an Associate Professor of Medicine with a cross appointment at the School of Epidemiology and Public Health at the University of Ottawa, a Scientist at the Ottawa Hospital Research Institute, and a Staff Nephrologist at the Ottawa Hospital. He received his MD from Vanderbilt University (2007). Following a 4-year stint as a flight surgeon in the US Air Force, he completed his internship and residency at Massachusetts General Hospital (2015) followed by nephrology fellowship at the joint Brigham and Women’s Hospital/Massachusetts General Hospital program (2018). He was recruited to Ottawa in 2018. His clinical and research interests focus on aldosterone-mediated kidney and cardiovascular disease. He is a former KRESCENT awardee and currently holds the Lorna Jocelyn Wood Chair in Kidney Research. His research has been funded by the CIHR, NIH, and Kidney Foundation of Canada.

Dr. Hundemer's Bio
pic_McFarlane

Phil
McFarlane

Dr. Phil McFarlane

Dr. Phil McFarlane is a clinical investigator in the Division of Nephrology at St. Michael's Hospital in Toronto, and an assistant professor at the University of Toronto.  At St. Michael’s he is the Medical Director of Home Dialysis and the Chief Nephrologist in the Live Kidney Donor Program.  He is a member of the Diabetes Canada Clinical Practice Guidelines group and the Canadian Society of Nephrology guideline group.  He has completed his Ph.D. in health economics at the Institute for Medical Sciences at the University of Toronto.  His areas of research interest include health economics and outcomes research.  He is currently the Ontario Renal Network Provincial Medical Lead for Hemodialysis.  He has published over 120 peer-reviewed manuscripts and three book chapters.

Dr. McFarlane's Bio
Reem-Mustafa

Reem A.
Mustafa

Dr. Reem A. Mustafa

Dr. Mustafa is a clinical nephrologist who is board certified in Preventive Medicine, Internal Medicine and Nephrology. She is especially interested in managing patients with chronic kidney disease and their other medical conditions to slow the progression of their disease.

Dr. Mustafa is very interested and formally trained in research with a master’s degree in public health and a PhD degree in Health Research Methodology/Clinical Epidemiology. Dr. Mustafa’s research interest focuses on the application of principles of evidence-based medicine in clinical and public health decision-making. She also studies the effect of these principles on clinical and patient-important outcomes. She is also interested in utilizing pragmatic clinical trials to study the effect of different feasible interventions to improve the outcomes and quality of life of patients with kidney disease. She is especially interested in decision-making regarding healthcare related tests and diagnostic strategies; challenges and suggested solutions, which included the use of models when direct evidence is lacking. She has extensive experience in the development and assessment of clinical practice guidelines through her work with The Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group and her role on the GRADE Guidance Group (Executive Committee). She has been involved with multiple guideline development groups internationally through the World Health Organization (WHO), the American Society of Hematology (ASH), American College of Physicians (ACP), The Infectious Disease Society of America (IDSA) among others. She is also the methods Co-Chair for the Kidney Disease: Improving Global Outcomes (KDIGO) methods committee. She is a co-founder of the U.S. GRADE network and the Evidence Foundation which mission is to support initiatives in evidence-based health care through training, mentorship, education, and collaboration with multidisciplinary teams.

Dr. Mustafa is passionate about improving decision-making in healthcare via collaborative efforts among a variety of interest holders including clinicians, patients and researchers. She is especially interested in implementing conceptual frameworks for interest holders’ engagement and methods for evaluating engagement for systematic reviews and guidelines development with a focus on engaging and empowering diverse and underserved populations.

Dr. Mustafa authored more than 390 peer reviewed publications with numerous methodological and clinical guidelines. She has been recognized as one of “true pioneers in their fields over the last decade demonstrated by the production of multiple highly cited papers that rank in the top 1% by citations in the Web of Science™” since 2021. She received multiple awards including the American Society of Nephrology Midcareer distinguished leadership award in 2025.

Dr. Mustafa's Bio
NADEAU-FREDETTE_Annie-Claire

Annie-Claire
Nadeau-Fredette

Dr. Annie-Claire Nadeau-Fredette

Dr. Annie-Claire Nadeau-Fredette is a Clinical scientist and Associate Professor of Clinical Medicine at the Université de Montréal. She is the Director of Home Dialysis and a staff nephrologist at Hôpital Maisonneuve-Rosemont. Dr. Nadeau-Fredette received her MD (2007), completed a Masters in Clinical Research (2016) at the Université de Montréal and home dialysis research fellowships at the University of Toronto (2013) and University of Queensland (2015). Dr. Nadeau-Fredette is a FRQS Junior 1 research scholar, has >50 publications and is involved in national and international studies in chronic kidney disease and dialysis. Her research program focuses primarily on improving outcomes of transitional periods for patients with advanced chronic kidney disease and on home dialysis.

Dr. Nadeau-Fredette's Bio
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Gihad
Nesrallah

Dr. Gihad Nesrallah

Dr. Nesrallah completed his medical training and nephrology fellowship at Western University, his MSc Health Research Methodology at McMaster University, and his MBA with the Kellogg-Schulich Executive program. His nephrology practice is based at Humber River Hospital in Toronto and he has faculty appointments at Western and the University of Toronto. His interests include observational epidemiology, quality improvement, and knowledge synthesis. He serves in various leadership and advisory roles in the public and private sectors in areas spanning data analytics, business strategy, quality improvement, and public policy. He is an avid chef and snowboarder, and a fortunate husband and father of 3 children.

Dr. Nesrallah's Bio
ODUTAYO-Ayodele

Ayodele
Odutayo

Dr. Ayodele Odutayo

Dr. Ayodele Odutayo is an Adult Nephrologist. He obtained his Doctor of Medicine degree at the University of Toronto in 2013 and completed his Master of Science (MSc) and Doctor of Philosophy (DPhil) in Epidemiology from 2013-2017, both at the University of Oxford as a Rhodes scholar. His research focuses on clinical trials examining cardiovascular and renal disease. He is co-funded by the Kidney Foundation of Canada and the Canadian Institutes of Health Research (CIHR) Research Excellence, Diversity, and Independence (REDI) Early Career Transition Award.

Dr. Odutayo's Bio
S Ramesh headshot

Sharanya
Ramesh

Dr. Sharanya Ramesh

Dr. Sharanya Ramesh, MD, PhD, is a postdoctoral research fellow at Tufts Medical Center and a practicing nephrologist at the University of Calgary. She earned both her MD and PhD from the University of Calgary, completed her internal medicine residency at the University of Toronto, and returned to Calgary for her nephrology fellowship. Her current research focuses on sex hormones and sex differences in glomerular filtration rate (GFR) estimation. More broadly, her interests include the influence of sex hormones on the diagnosis and management of chronic kidney disease (CKD), CKD risk associated with menopause, and the relationship between physical function and CKD.

Dr. Ramesh's Bio
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Krista
Ryz

Dr. Krista Ryz

Dr. Krista Ryz is an academic nephrologist and Medical Director of the Renal Program at St. Boniface Hospital. Although she primarily identifies as a clinician, her research has focused on quality improvement initiatives designed to refine clinical practices and optimize patient management. She is committed to pragmatic projects that ensure the highest quality of care is being delivered to patients in the most efficient way. This has led to her current efforts on improving care for patients living with diabetic kidney disease.

Dr. Ryz's Bio
SCHORR_Melossa

Melissa
Schorr

Dr. Melissa Schorr

Dr. Schorr completed her Internal Medicine, and Nephrology training,  and Clinician Investigator Program at Western University. She is a Clinical Lecturer and Nephrologist at the Cumming School of Medicine in Calgary and the Physician Lead for their Conservative Kidney Management program. She is passionate about delivering the best possible care based on quality evidence to support people living with kidney disease.

Dr. Schorr's Bio
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Michelle
Wong

Dr. Michelle Wong

Dr. Michelle Wong, MD, MSc, MPH, FRCPC, is a Clinical Assistant Professor in the Department of Medicine at the University of British Columbia, and a clinical researcher at BC Renal. She is also a 2021 cohort member of the International Society of Nephrology Emerging Leaders Program. Dr. Wong’s research has focused on complications of chronic kidney disease, including protein-energy wasting, anemia, volume overload, and hypertension. She has been involved in systematic reviews the World Hypertension League’s “Science of Sodium” initiative, as well as international cohort studies with the Dialysis Outcomes and Practice Patterns Study, and the Chronic Kidney Disease Outcomes and Practice Patterns Study. At BC Renal, she is currently leading an interprofessional research program in renal nutrition.

Dr. Wong's Bio
KevinYau Headshot

Kevin
Yau

Dr. Kevin Yau

Dr. Kevin Yau is a Nephrologist at the University Health Network and the Department of Medicine at the University of Toronto. He received his medical degree from the University of Toronto in 2016 and completed Internal Medicine training at Western University. This was followed by General Nephrology Fellowship, a Cardiovascular, Renal, Endocrinology and Metabolic Diseases Fellowship, and Glomerulonephritis Fellowship at the University of Toronto. He has graduate research training in clinical epidemiology and completed further postdoctoral research supported by the Kidney Foundation of Canada and the Health Data Research Network Canada Pragmatic Trials Training Program. His current research interests include evaluating therapies for cardiovascular-kidney-metabolic syndrome and glomerulonephritis.

Dr. Yau's Bio

Emeritus Members

mathew

Anna
Mathew

Dr. Anna Mathew

Dr. Anna Mathew completed medical school at University of Toronto, and Internal Medicine residency and Nephrology fellowship at Western University. She then completed an MPH (Quantitative Methods) at Harvard University.  Dr. Mathew is Associate Professor of Medicine at McMaster University and a staff nephrologist at St. Joseph’s HealthCare Hamilton. Her clinical interests include chronic kidney disease, resistant or secondary hypertension, and obstetrical nephrology.  She previously served as Chair of CSN's Clinical Practice Guidelines committee from 2021-2024.    

Dr. Mathew's Bio
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