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Not enough evidence to screen all adults for CKD, task force says

August 28, 2012
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There is not enough evidence to assess the benefits and harms of routine screening of asymptomatic adults for chronic kidney disease, reports the U.S. Preventive Services Task Force. This recommendation applies to asymptomatic adults without diagnosed CKD, diabetes or hypertension, the task force said.

"No studies assess the sensitivity and specificity of screening for CKD with tests for estimated GFR, microalbuminuria, or macroalbuminuria," according to a statement released by the task force. "Evidence that routine screening for CKD improves clinical outcomes for asymptomatic adults is inadequate. However, convincing evidence shows that medications used to treat early CKD may have adverse effects."

The task force also said that there is a potential for false positives in CKD screening and people who test positive but do not actually have CKD will experience the harms of early treatment without any of the benefits.

More research is needed to explore the reasons for and possible interventions to prevent the disproportionate progression to end-stage renal disease in African Americans, the task force said. More research is needed on the potential benefits and harms of screening and early treatment of CKD in persons without diabetes or hypertension, and studies that evaluate the effect of screening for CKD in patients with hypertension but not diabetes would help to define the benefits and harms of screening in this risk group.

The task force said it found very limited evidence about whether knowledge of CKD status in patients with hypertension but without diabetes or cardiovascular disease helps in making treatment decisions. The task force noted that several organizations recommend screening patients who are being treated for hypertension, including the National Institutes of Health''s Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure.

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