TUESDAY, Oct. 22 (HealthDay News) -- The American College of Physicians (ACP) has presented recommendations for the screening, monitoring, and treatment of adults with chronic kidney disease, according to guidelines published online Oct. 22 in the Annals of Internal Medicine.
Amir Qaseem, M.D., Ph.D., M.H.A., and colleagues for the Clinical Guidelines Committee of the ACP in Philadelphia, conducted a systematic evidence review of the published literature to develop guidelines on the screening, monitoring, and treatment of adults with stage 1 to 3 chronic kidney disease.
The authors present four recommendations: the first against screening asymptomatic adults without risk factors for chronic kidney disease (weak recommendation; low-quality evidence). For adults with or without diabetes who are currently taking an angiotensin-converting enzyme inhibitor or an angiotensin II-receptor blocker, the ACP recommends against testing for proteinuria (weak recommendation; low-quality evidence). For patients with hypertension and stage 1 to 3 chronic kidney disease, the ACP recommends clinicians select pharmacologic therapy that includes either an angiotensin-converting enzyme inhibitor or an angiotensin II-receptor blocker (strong recommendation; moderate- and high-quality evidence, respectively). For patients with stage 1 to 3 chronic kidney disease, the ACP recommends clinicians choose statin therapy to manage elevated low-density lipoprotein (strong recommendation; moderate-quality evidence).
"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 authors write.
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