In asymptomatic adults without risk factors, screening for chronic kidney disease (CKD) is unnecessary, suggests the American College of Physicians (ACP).

ACP recommends against testing for proteinuria in adults with or without diabetes who are currently taking an angiotensin-converting-enzyme (ACE) inhibitor or an angiotensin II receptor blocker (ARB). For treatment, ACP recommends treating patients with hypertension and stage 1-3 CKD with either an ACE inhibitor or an ARB. ACP recommends a statin therapy to manage elevated low density lipoprotein in patients with stage 1-3 CKD. Head-to-head trials showed no difference in the outcomes between ACE inhibitors or ARBs. The risk of adverse effects significantly increased with an ACE inhibitor combined with an ARB combination therapy, including cough, hyperkalemia, hypotension, and acute kidney failure requiring dialysis.
ACP's guideline also includes advice to help physicians practice high value care. "Ordering lab tests is not going to have any impact on clinical outcomes of asymptomatic patients with CKD without risk factors but will add unnecessary costs to the health care system due to increased medical visits and unnecessary tests," Dr. Cooke said. ACP also found the evidence inconclusive for periodic laboratory monitoring of patients diagnosed with stage 1-3 CKD.
Source-Eurekalert