In a letter to the Coalition for Kidney Health (C4KH), the United States Preventative Services Task Force (USPSTF) recently accepted the nomination of chronic kidney disease (CKD) screening for evaluation to potentially become a future recommendation.
Focused on improving health across the nation, USPSTF offers evidence-based recommendations about clinical preventive services. The C4KH, which is led by the National Kidney Foundation (NKF) and joined by the American Society of Nephrology (ASN) as a founding member, is a multi-stakeholder group of partners working to transform the landscape of CKD management by generating awareness, increasing screening of at-risk patients, and advancing high-quality, coordinated care.
Advocacy to advance this request by the coalition began in 2020. The C4KH wrote to USPSTF in December 2020 and generated outreach on Capitol Hill to solicit letters of support from members of Congress.
“Improvements to slow or stop the progression of kidney diseases are urgently needed,” said ASN President Susan E. Quaggin, MD, FASN. “Having USPSTF prioritize screening for CKD is a key priority for ASN, and it aligns well with the society’s goal to ensure we intervene earlier, which will fundamentally reposition nephrology as part of early detection and treatment.” Dr. Quaggin added, “ASN applauds the efforts of the Coalition for Kidney Health, NKF, and other members of the kidney community for their continued work on this front. If USPSTF prioritizes screening for CKD, ASN is committed to working with the task force to finalize their draft research plan.”
In 2012, after considering inclusion of CKD screening in its recommendations, USPSTF concluded, “that the evidence on routine screening for CKD in asymptomatic adults is lacking, and that the balance of benefits and harms cannot be determined.”
In a C4KH request letter, the group noted the many changes in kidney care since 2012 and the continuing pressing need of CKD screening. “Since that time, CKD progression has become increasingly modifiable. In fact, there are at least two and potentially three drug classes of treatment options for CKD that did not exist in 2012. These new advances in slowing CKD progression add weight to the benefits of CKD screening in asymptomatic high-risk patients. Furthermore, as the nation reinvigorates the conversation about health disparities, we note that African Americans are more likely to have diabetes, the leading cause of CKD, and more likely to suffer its consequences including kidney failure and death. CKD screening has never been more important and, at the intersection of novel science and public health need, the benefits outweigh any theoretical harms of screening these asymptomatic patients at high risk of CKD.”
Before the COVID-19 pandemic, there was rapid growth of societal support for the need of racial and ethnic equality in policy, and during the pandemic, COVID-19 has brought even more glaring disparities in our public health system to light. Racial and ethnic minority groups have been disproportionately affected by COVID-19 and disparities continue in kidney health. CKD is a serious public health issue that affects 37,000,000 Americans and disproportionately affects communities of color. Screening for CKD could not only intervene in the progression of this debilitating disease, it could also provide ease in quality of life to the communities most affected.