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Role of Screening, Monitoring in Early Kidney Disease Unclear
Date:4/17/2012

By Serena Gordon
HealthDay Reporter

TUESDAY, April 17 (HealthDay News) -- At least one in 10 U.S. adults is estimated to have chronic kidney disease, but whether screening and monitoring people in the earlier stages of the disease provides a benefit just isn't clear, a new review of the available clinical trials revealed.

The finding doesn't necessarily mean that early screening or monitoring of kidney disease isn't helpful, it just shows no clear evidence to prove that it is. "We didn't find direct evidence for benefits or harms. There were no randomized controlled trials for screening or monitoring," said the study's lead author, Dr. Howard Fink, a staff physician at the Veterans Affairs Medical Center in Minneapolis, Minn.

But, when the reviewers looked at the treatment options available to people with early-stage chronic kidney disease, they found evidence that two types of blood pressure-lowering medication reduced progression to end-stage kidney disease and one medication reduced the risk of death.

The two medication classes were angiotensin-converting enzyme (ACE) inhibitors and angiotensin II-receptor blockers (ARBs). The benefits from these medications were stronger in people who had worsening kidney disease and those with diabetes, according to the review.

Results of the review are published in the April 17 issue of the Annals of Internal Medicine.

Eleven percent of American adults have chronic kidney disease in its earliest stages (one through three), according to the review. Chronic kidney disease is more likely to occur in older people, and those with other chronic medical conditions, such as heart disease, high blood pressure and diabetes. Most people don't have symptoms of early chronic kidney disease. It is detected through urine and blood tests.

Not everyone with chronic kidney disease will develop end-stage renal disease and need dialysis, but having early chronic k
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