What question did this study set out to answer?

This guideline aims to provide evidence-based recommendations for the screening, monitoring, and treatment of adults with stage 1 to 3 chronic kidney disease.

October 22, 2013Annals of Internal Medicine

Screening, Monitoring, and Treatment of Stage 1 to 3 Chronic Kidney Disease: A Clinical Practice Guideline From the American College of Physicians

Q: What is the clinical evidence from this study?

Study design: Systematic Review. Population: stage 1 to 3 chronic kidney disease. Intervention: Screening, monitoring, and pharmacologic therapy. Primary outcome: all-cause mortality, cardiovascular mortality, myocardial infarction, stroke, chronic heart failure, composite vascular outcomes, composite renal outcomes, end-stage renal disease, quality of life, physical function, and activities of daily living.

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Why the study?

What are the evidence-based recommendations for screening, monitoring, and treating adults with stage 1 to 3 chronic kidney disease?

Population

Adults with stage 1 to 3 chronic kidney disease, and asymptomatic adults without risk factors for chronic…

Design

Guideline

Authors

AQAmir QaseemAmerican College of Physicians RHRobert HopkinsUniversity of Arkansas for Medical Sciences DSDonna E. SweetWest Los Angeles College

Discussion

Member takes

Implication

Reduces unnecessary screening in low-risk adults; confirms ACEi/ARB and statin benefits for stage 1-3 CKD.

Key Points

This guideline aims to provide evidence-based recommendations for the screening, monitoring, and treatment of adults with stage 1 to 3 chronic kidney disease.
Conducted systematic evidence review from 1985 through November 2011 using MEDLINE and Cochrane Database.
Evaluated clinical outcomes including mortality, cardiovascular events, and quality of life.
Graded evidence and recommendations based on ACP's grading system.
Recommends against screening asymptomatic adults without risk factors for chronic kidney disease (weak recommendation, low-quality evidence).
Suggests against proteinuria testing in patients on ACE inhibitors or ARBs (weak recommendation, low-quality evidence).
Strongly recommends use of ACE inhibitors or ARBs for hypertensive patients with stage 1 to 3 kidney disease (moderate to high-quality evidence).

Study Design

Type

Systematic Review

Structured PICO

What are the evidence-based recommendations for screening, monitoring, and treating adults with stage 1 to 3 chronic kidney disease?

Population

Adults with stage 1 to 3 chronic kidney disease, and asymptomatic adults without risk factors for chronic kidney disease

Intervention

Screening, monitoring (proteinuria testing), and pharmacologic treatment (ACE inhibitors, ARBs, statins)

Outcome

Clinical outcomes including all-cause mortality, cardiovascular mortality, myocardial infarction, stroke, chronic heart failure, composite vascular outcomes, composite renal outcomes, end-stage renal disease, quality of life, physical function, and activities of daily livinghard clinical

This ACP guideline provides evidence-based recommendations for the management of stage 1 to 3 CKD, emphasizing targeted screening and the use of ACEi/ARBs and statins to improve clinical outcomes.

Cite This Study

Qaseem et al. (2013) conducted a systematic review in stage 1 to 3 chronic kidney disease. Screening, monitoring, and pharmacologic therapy was evaluated on all-cause mortality, cardiovascular mortality, myocardial infarction, stroke, chronic heart failure, composite vascular outcomes, composite renal outcomes, end-stage renal disease, quality of life, physical function, and activities of daily living. The ACP recommends against screening for CKD in asymptomatic adults without risk factors, and recommends ACE inhibitors or ARBs and statins for patients with stage 1 to 3 chronic kidney disease.

synapsesocial.com/papers/6a216b8ecdf8429e7e5fa7eb https://doi.org/10.7326/0003-4819-159-12-201312170-00726

Topics

Statin therapy

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Screening, Monitoring, and Treatment of Stage 1 to 3 Chronic Kidney Disease: A Clinical Practice Guideline From the American College of Physicians

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Topics

Screening, Monitoring, and Treatment of Stage 1 to 3 Chronic Kidney Disease: A Clinical Practice Guideline From the American College of Physicians

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

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