Adeera Levin, MD; Paul E. Stevens, MD; Josef Coresh, MD; Andrew Levey, MD
Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L14-0089.
Levin A., Stevens P., Coresh J., Levey A.; Screening, Monitoring, and Treatment of Stage 1 to 3 Chronic Kidney Disease. Ann Intern Med. 2014;161:81-82. doi: 10.7326/L14-5013-2
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Published: Ann Intern Med. 2014;161(1):81-82.
TO THE EDITOR:
We believe that Qaseem and colleagues’ guideline (1) lacks context and clarity and is not consistent with the recent Kidney Disease: Improving Global Outcomes (KDIGO) guideline (2). Consequently, the recommendations may confuse readers and negatively affect physician practice and patient care.
Recommendation 1 forswears screening for CKD in asymptomatic adults without risk factors. All published guidelines agree with this recommendation, and neither the KDIGO guideline nor the Kidney Disease Outcomes Quality Initiative guideline that preceded it advocates screening the general population (2). We are uncertain why the recommendation is written as a negative. It would be more useful to describe who should be screened (that is, adults with risk factors for CKD, including diabetes, hypertension, and a family history of CKD). If the intention is to highlight that screening the general population is not recommended, then that should be stated.
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