On behalf of the 37 million adults in America with kidney diseases, including the over 90 percent who are unaware that they have chronic kidney disease, the American Society of Nephrology and the National Kidney Foundation express our concern that the United States Preventive Services Task Force (USPSTF) Final Research Agenda for chronic kidney disease (CKD) screening continues to focus on screening only of asymptomatic, low-risk individuals. By examining this issue from such a broad purview, the USPSTF risks overlooking or diluting the significant evidence that supports screening for at-risk populations.
We are also concerned that the USPSTF overstates current clinical practice guidelines for screening in hypertensive populations, which list albuminuria testing as optional. Furthermore, illustrating the urgent need to evaluate benefits of screening, among adults with diabetes for whom annual albuminuria testing is recommended by clinical practice guidelines, only approximately 40% of adults with diabetes receive albuminuria screening each year.
Simply put, far too many high-risk individuals, many from historically disadvantaged and marginalized groups with burdensome social determinants of health and limited or inconsistent access to quality health care, have undiagnosed CKD and therefore are untreated for their elevated risk of cardiovascular disease, kidney failure, and death. While we are confident that the evidence will ultimately demonstrate the value of CKD screening, we urge USPSTF to expand its approach so that we can have a greater impact on increasing diagnosis of those with, or at most at risk for CKD.