Screening, Monitoring, and Treatment of Stage 1 to 3 Chronic Kidney Disease
Authors: Adeera Levin, Paul E. Stevens, Josef Coresh, Andrew Levey
Journal: Annals of Internal Medicine (2014)

Letters1 July 2014Screening, Monitoring, and Treatment of Stage 1 to 3 Chronic Kidney DiseaseAdeera Levin, MD, Paul E. Stevens, MD, Josef Coresh, MD, and Andrew Levey, MDAdeera Levin, MDFrom University of British Columbia, Vancouver, British Columbia, Canada; East Kent Hospitals University NHS Trust, Canterbury, United Kingdom; Johns Hopkins University, Baltimore, Maryland; and Tufts Medical Center, Boston, Massachusetts.Search for more papers by this author, Paul E. Stevens, MDFrom University of British Columbia, Vancouver, British Columbia, Canada; East Kent Hospitals University NHS Trust, Canterbury, United Kingdom; Johns Hopkins University, Baltimore, Maryland; and Tufts Medical Center, Boston, Massachusetts.Search for more papers by this author, Josef Coresh, MDFrom University of British Columbia, Vancouver, British Columbia, Canada; East Kent Hospitals University NHS Trust, Canterbury, United Kingdom; Johns Hopkins University, Baltimore, Maryland; and Tufts Medical Center, Boston, Massachusetts.Search for more papers by this author, and Andrew Levey, MDFrom University of British Columbia, Vancouver, British Columbia, Canada; East Kent Hospitals University NHS Trust, Canterbury, United Kingdom; Johns Hopkins University, Baltimore, Maryland; and Tufts Medical Center, Boston, Massachusetts.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L14-5013-2 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We believe that Qaseem and colleagues’ guideline (1) lacks context and clarity and is not consistent with the recent Kidney Disease: Improving Global Outcomes (KDIGO) guideline (2). Consequently, the recommendations may confuse readers and negatively affect physician practice and patient care.Recommendation 1 forswears screening for CKD in asymptomatic adults without risk factors. All published guidelines agree with this recommendation, and neither the KDIGO guideline nor the Kidney Disease Outcomes Quality Initiative guideline that preceded it advocates screening the general population (2). We are uncertain why the recommendation is written as a negative. It would be more ...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. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl. 2013;3:1-150. Google Scholar3. Kidney Disease: Improving Global Outcomes (KDIGO) Blood Pressure Work Group. KDIGO clinical practice guideline for the management of blood pressure in chronic kidney disease. Kidney Int Suppl. 2012;2:337-414. Google Scholar4. Tomlinson LA, Abel GA, Chaudhry AN, Tomson CR, Wilkinson IB, Roland MO, et al. ACE inhibitor and angiotensin receptor-II antagonist prescribing and hospital admissions with acute kidney injury: a longitudinal ecological study. PLoS One. 2013;8:e78465. [PMID: 24223154] CrossrefMedlineGoogle Scholar5. Kidney Disease: Improving Global Outcomes (KDIGO) Lipid Work Group. KDIGO clinical practice guideline for lipid management in chronic kidney disease. Kidney Int Suppl. 2013;3:259-305. Google Scholar Author, Article, and Disclosure InformationAffiliations: From University of British Columbia, Vancouver, British Columbia, Canada; East Kent Hospitals University NHS Trust, Canterbury, United Kingdom; Johns Hopkins University, Baltimore, Maryland; and Tufts Medical Center, Boston, Massachusetts.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L14-0089. 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 Gauranga C. Dhar 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 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 Gauranga C. Dhar Metrics Cited byReducing the costs of chronic kidney disease while delivering quality health care: a call to actionPrevalence and determinants of chronic kidney disease in northeast of Iran: Results of the Golestan cohort studyThe next generation of therapeutics for chronic kidney disease 1 July 2014Volume 161, Issue 1Page: 81-82KeywordsACE inhibitorsDisclosureHypertensionMedical risk factorsProteinuriaRenal diseasesStatinsTreatment guidelines ePublished: 1 July 2014 Issue Published: 1 July 2014 Copyright & PermissionsCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...