Objective To establish a standardized diagnostic and treatment pathway for chronic renal failure (CRF) based on a nephrology cluster, providing a reference for the traditional Chinese medicine (TCM) diagnosis and treatment of CRF.

Methods A TCM diagnostic and treatment protocol for CRF was developed through cluster construction. A preliminary framework for the standardized diagnostic and treatment pathway of CRF was constructed through literature research. Three rounds of Delphi expert consultation were conducted among 26 experts. The experts′enthusiasm, authority, coordination of opinions, importance ratings, and coefficient of variation were analyzed to ultimately form the standardized diagnostic and treatment pathway for CRF.

Results The active coefficients (Caj) for the first, second, and third rounds of expert consultation were 1.000, 0.923, and 1.000, respectively. The expert authority coefficients (Cr) were 0.895, 0.910, and 0.923, respectively. The overall Kendall's W coefficients were 0.233, 0.248, and 0.293 (P < 0.001). The final standardized diagnostic and treatment pathway for CRF included 4 primary indicators, 19 secondary indicators, and 77 tertiary indicators, with mean importance ratings ranging from 4.42 to 4.87 and coefficients of variation ranging from 0.072 to 0.126.

Conclusion The standardized diagnostic and treatment pathway for CRF established based on a nephrology cluster is highly scientific and reliable, with clear guidance and ease in implementation, providing good guidance for the TCM diagnosis and treatment of CRF.