Nephrology Society Objects to Call Against Kidney Screening

The American Society of Nephrology (ASN) is at odds with the new American College of Physicians (ACP) recommendation against screening for chronic kidney disease in asymptomatic adults without risk factors for the condition.

In a statement issued one day after the new ACP clinical guidelines, published by Annals of Internal Medicine, came out against chronic kidney disease (CKD) screening in asymptomatic adults who do not have risk factors, the ASN confirmed that it “strongly recommends” regular screening for kidney disease, regardless of an individual's risk factors.

“ASN and its nearly 15,000 members—all of whom are experts in kidney disease—are disappointed by ACP's irresponsible recommendation,” asserted ASN executive director Todd Ibrahim in the statement.

Amir Qaseem, MD, PhD, MHA, and coauthors from the ACP's Clinical Guidelines Committee concluded that the recommendation against CKD screening of asymptomatic adults without CKD risk factors is supported by weak/low-quality evidence. The group's research had identified no randomized, controlled trials that compared the effect of systematic CKD screening versus no CKD screening on clinical outcomes or that evaluated the harms of such screening.

The ASN contends that because CKD is largely asymptomatic in its early stages, early detection and intervention can slow progression of the disease and help patients maintain vital kidney function and quality of life.

The ASN also disagrees with the ACP's recommendation against testing for proteinuria in adults taking an ACE inhibitor or an angiotensin II receptor blocker. Citing high blood pressure and diabetes as the two leading risk factors for the development of CKD, the ASN “emphasizes the importance” of proteinuria testing in adults being treated with antihypertensive medications.

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