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ACP Advises Against Chronic Kidney Disease Screening in Asymptomatic Adults — Physician’s First Watch

Medical News |
October 22, 2013

ACP Advises Against Chronic Kidney Disease Screening in Asymptomatic Adults

By Kelly Young

The American College of Physicians now recommends against screening for chronic kidney disease in asymptomatic adults who don't have CKD risk factors.

In new guidelines published in the Annals of Internal Medicine, the authors write: "In the absence of evidence that screening improves clinical outcomes, testing will add costs, owing to both the screening test and to additional follow-up tests (including those resulting from false-positive findings), increased medical visits, and costs of keeping or obtaining health insurance."

The guidelines also recommend:

  • against proteinuria testing in adults (with or without diabetes) taking an angiotensin-converting enzyme (ACE) inhibitor or angiotensin II-receptor blocker (ARB);

  • treating patients with hypertension and stage 1 to 3 CKD with an ACE inhibitor or ARB;

  • prescribing statins to patients with elevated LDL cholesterol and stage 1 to 3 CKD.

Reader Comments (2)

SHARON MCCAULEY

CKD is known as a "silent disease" since patients often do not present with symptoms early on, nor do they have a known family history (though most likely have risk factors); thus, the longstanding preventative medicine practice of objective testing/screening at annual physicals. Moreover, not screening for CKD may also lead to not identifying the "silent killer" - RCC (renal cell carcinoma).

Ever since the ACA, it seems we are increasingly being advised by medical groups that screening is not necessary or can be pushed off by a decade - until it may be too late to treat due to the progression of the disease and/or the age of the patient.

I guess then we all have to ask ourselves the reason we are then in the healthcare profession or in the case of this recommendation the healthcare business.

Jack Shapiro M.D Physician, Internal Medicine, Retired

Probably the dumbest think I had ever read in more than 50 ears of medical practice. Proves the adages 1.If you don't know keep your mouth shut and nobody will know how stupid you are. 2.Meta-analysis is ti analysis as metaphysics is to physics. No REAL physician who actually sees patients instead of reading some elses gibberish will take this seriously.

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