Screening, Monitoring, and Treatment of Stage 1 to 3 Chronic Kidney Disease

Letters1 July 2014Screening, Monitoring, and Treatment of Stage 1 to 3 Chronic Kidney DiseaseAmir Qaseem, MD, PhD, MHA, Timothy Wilt, MD, MPH, and Thomas D. Denberg, MD, PhDAmir Qaseem, MD, PhD, MHAFrom American College of Physicians, Philadelphia, Pennsylvania; Minneapolis VA Center for Epidemiological and Clinical Research, Minneapolis, Minnesota; and Carilion Clinic, Roanoke, Virginia., Timothy Wilt, MD, MPHFrom American College of Physicians, Philadelphia, Pennsylvania; Minneapolis VA Center for Epidemiological and Clinical Research, Minneapolis, Minnesota; and Carilion Clinic, Roanoke, Virginia., and Thomas D. Denberg, MD, PhDFrom American College of Physicians, Philadelphia, Pennsylvania; Minneapolis VA Center for Epidemiological and Clinical Research, Minneapolis, Minnesota; and Carilion Clinic, Roanoke, Virginia.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L14-5013-5 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Dhar states that the only harm of screening tests for CKD is financial; we disagree. Screening is a process, not just a simple test, that results in a cascade of additional diagnostic and treatment events. In addition to the expense of the screening test (which may be low), there are costs associated with follow-up evaluation of abnormal results, unnecessary treatment and complications, and adverse effects of treatment. The overuse of screening tests is an important component of unnecessary health care costs in the United States (1). Recommending against CKD screening for asymptomatic patients without risk factors provides ...References1. Owens DK, Qaseem A, Chou R, Shekelle P; Clinical Guidelines Committee of the American College of Physicians. High-value, cost-conscious health care: concepts for clinicians to evaluate the benefits, harms, and costs of medical interventions. Ann Intern Med. 2011;154:174-80. [PMID: 21282697] LinkGoogle Scholar2. Harris R. Overview of screening: where we are and where we may be headed. Epidemiol Rev. 2011;33:1-6. [PMID: 21709142] CrossrefMedlineGoogle Scholar3. Wilson JMG, Jungner G. Principles and Practice of Screening for Disease. Geneva: World Health Organization; 1968. Google Scholar Author, Article, and Disclosure InformationAffiliations: From American College of Physicians, Philadelphia, Pennsylvania; Minneapolis VA Center for Epidemiological and Clinical Research, Minneapolis, Minnesota; and Carilion Clinic, Roanoke, Virginia.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M12-3186. 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 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 Khaled Abdel-Kader 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 Gauranga C. Dhar Metrics Cited ByA Novel NiFe2O4/Paper-Based Magnetoelastic Biosensor to Detect Human Serum Albumin 1 July 2014Volume 161, Issue 1Page: 83-84KeywordsACE inhibitorsChronic kidney diseaseCreatinineDisclosureHypertensionMedical risk factorsProteinuriaSystematic reviews ePublished: 1 July 2014 Issue Published: 1 July 2014 CopyrightCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...