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Screening for Chronic Kidney Disease: U.S. Preventive Services Task Force Recommendation Statement FREE

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This article was published at www.annals.org on 28 August 2012.


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Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians.


Ann Intern Med. 2012;157(8):I-50. doi:10.7326/0003-4819-157-8-201210160-00534
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Who developed these recommendations?

The U.S. Preventive Services Task Force (USPSTF) is a group of health experts that makes recommendations about preventive health care.

What is the problem and what is known about it so far?

The kidneys remove waste and water from the blood. In chronic kidney disease (CKD), kidney function may worsen over time. In a small number of people with CKD, the kidneys will stop working. When the kidneys stop working, dialysis is needed to filter the blood using machines. Caring for CKD involves controlling diet and blood pressure and taking medications to delay heart complications and the need for dialysis. Many patients do not know that they have CKD and do not receive care to delay complications.

Glomerular filtration rate is a measure of kidney function and can be estimated using equations that are based on the measurement of levels of creatinine, a substance in the blood. It is also possible to look for CKD by measuring urinary levels of a substance called albumin. Chronic kidney disease is most common in people with high blood pressure or diabetes, and people with these conditions should talk to their doctors about being periodically tested for CKD. However, CKD can occur in apparently healthy people who do not have high blood pressure or diabetes. For this reason, the USPSTF aimed to determine whether routine screening of healthy adults for CKD would improve patient outcomes.

How did the USPSTF develop these recommendations?

The USPSTF reviewed research about the potential accuracy, benefits, and harms of screening for CKD. It also reviewed research about the benefits and harms of early versus later treatment of CKD.

What did the authors find?

The USPSTF found that studies are lacking to show whether screening healthy adults for CKD improves outcomes. Although there are no direct studies of the harms of screening, the medications used to treat early CKD can have side effects.

What does the USPSTF recommend that patients and doctors do?

The USPSTF concluded that there is not enough evidence to recommend either for or against screening healthy people for CKD.

Patients who have diabetes, high blood pressure, or bad cholesterol levels should generally be treated for these conditions regardless of whether they also have CKD.

What are the cautions related to these recommendations?

These recommendations do not apply to people with diabetes, high blood pressure, or symptoms that could be caused by CKD.

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