The paucity of evidence supporting screening for stages 1-3 CKD in asymptomatic patients with or without risk factors

Area of Science:

• Nephrology
• Preventive Medicine
• Clinical Guidelines

Background:

• The American College of Physicians (ACP) issued a guideline on chronic kidney disease (CKD) screening.
• Population-based screening requires demonstrated benefits for clinical outcomes and minimal harm.
• CKD screening in asymptomatic individuals without risk factors is debated.

Purpose of the Study:

• To evaluate the ACP's recommendation against CKD screening in asymptomatic adults without risk factors.
• To assess whether CKD screening meets established criteria for population-based screening programs.
• To examine the evidence for benefits and harms associated with screening asymptomatic individuals without risk factors.

Main Methods:

• Review of the ACP's guideline on CKD screening.
• Analysis of general criteria for population-based disease screening.
• Evaluation of existing evidence regarding early treatment benefits for screened individuals without risk factors.
• Assessment of potential harms associated with CKD screening.

Main Results:

• CKD screening in asymptomatic adults without risk factors does not meet established criteria for population-based screening.
• There is a lack of evidence demonstrating clinical benefits from early treatment for individuals identified through screening who lack risk factors.
• Potential harms of CKD screening include false-positive results, unnecessary diagnostic procedures, and the psychosocial impact of disease labeling.

Conclusions:

• The ACP's recommendation against CKD screening in asymptomatic adults without risk factors is supported by current evidence.
• Screening for CKD in this population does not appear to improve clinical outcomes and may lead to harm.
• Further research is needed to establish the value of early intervention for individuals identified through screening without traditional risk factors.