Screening, Monitoring, and Treatment of Stage 1 to 3 Chronic Kidney Disease
Authors: Gauranga C. Dhar
Journal: Annals of Internal Medicine (2014)

Letters1 July 2014Screening, Monitoring, and Treatment of Stage 1 to 3 Chronic Kidney DiseaseGauranga C. Dhar, MDGauranga C. Dhar, MDFrom Bangladesh Institute of Family Medicine and Research, Dhaka, Bangladesh.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L14-5013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:I do not agree with Qaseem and colleagues' (1) recommendation not to screen asymptomatic persons for chronic kidney disease (CKD). Type 2 diabetes and hypertension are the most common conditions causing CKD. Patients with stage 3 CKD and most patients with stage 4 CKD are usually asymptomatic, and CKD can be named a "silent killer."Chronic kidney disease in asymptomatic persons is detected earliest by measurement of the estimated glomerular filtration rate (eGFR) and urinary albumin–creatinine ratio, preferably done twice on different dates. These simple and inexpensive tests do not harm patients; I believe that the only ...References1. Qaseem A, Hopkins RH, Sweet DE, Starkey M, Shekelle P; Clinical Guidelines Committee of the American College of Physicians. Screening, monitoring, and treatment of stage 1 to 3 chronic kidney disease: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2013;159:835-47. [PMID: 24145991] LinkGoogle Scholar2. Lane PH, Steffes MW, Mauer SM. Glomerular structure in IDDM women with low glomerular filtration rate and normal urinary albumin excretion. Diabetes. 1992;41:581-6. [PMID: 1568527] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Bangladesh Institute of Family Medicine and Research, Dhaka, Bangladesh.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L14-0086. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoHigh-Value, Cost-Conscious Health Care: Concepts for Clinicians to Evaluate the Benefits, Harms, and Costs of Medical Interventions Douglas K. Owens , Amir Qaseem , Roger Chou , Paul Shekelle , and Screening, Monitoring, and Treatment of Stage 1 to 3 Chronic Kidney Disease Adeera Levin , Paul E. Stevens , Josef Coresh , and Andrew Levey Screening, Monitoring, and Treatment of Stage 1 to 3 Chronic Kidney Disease Hiddo J. Lambers Heerspink , Carlo J.A.M. Gaillard , and Ron T. Gansevoort Screening, Monitoring, and Treatment of Stage 1 to 3 Chronic Kidney Disease Khaled Abdel-Kader Screening, Monitoring, and Treatment of Stage 1 to 3 Chronic Kidney Disease Amir Qaseem , Timothy Wilt , and Thomas D. Denberg Screening, Monitoring, and Treatment of Stage 1 to 3 Chronic Kidney Disease Khaled Abdel-Kader Screening, Monitoring, and Treatment of Stage 1 to 3 Chronic Kidney Disease Amir Qaseem , Timothy Wilt , and Thomas D. Denberg Screening, Monitoring, and Treatment of Stage 1 to 3 Chronic Kidney Disease Adeera Levin , Paul E. Stevens , Josef Coresh , and Andrew Levey Screening, Monitoring, and Treatment of Stage 1 to 3 Chronic Kidney Disease Hiddo J. Lambers Heerspink , Carlo J.A.M. Gaillard , and Ron T. Gansevoort Metrics 1 July 2014Volume 161, Issue 1Page: 81KeywordsAlbuminsCardiovascular disease riskChronic kidney diseaseExcretionHealth surveysHypertensionRenal failureScreening guidelinesType 2 diabetes ePublished: 1 July 2014 Issue Published: 1 July 2014 Copyright & PermissionsCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...