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Management of Chronic Kidney Disease Stages 1–3
Gaps in Knowledge
The systematic review identified areas where clear evidence is not available:
Whether clinical outcomes are improved from systematic screening for CKD in patients at high risk for developing CKD (e.g., patients with diabetes, hypertension, or CV disease) or systematic CKD monitoring for worsened kidney function or damage, especially in patients with CKD who also have hypertension, diabetes, or CV disease
- If one-time measures of albuminuria or eGFR have the specificity and sensitivity to diagnose persistent CKD or CKD progression
- Whether the clinical outcome benefits differ for a specific treatment between patients with recently worsened kidney function or damage (as detectable by monitoring) when compared with those with stable CKD
- The long-term impact of treatment on clinical outcomes
- The impact of dietary intervention or intensification of treatment (e.g., tight vs. standard blood pressure control, high vs. standard statin dose) on clinical outcomes for patients with CKD stages 1–3
CKD = chronic kidney disease; CV = cardiovascular; eGFR = estimated glomerular filtration rate
- Fink HA, Ishani A, Taylor BC, et al. Chronic Kidney Disease Stages 1–3: Screening, Monitoring, and Treatment. Comparative Effectiveness Review No. 37 (Prepared by the Minnesota Evidence-based Practice Center under Contract No. HHSA 290-2007-10064-I). Rockville, MD: Agency for Healthcare Research and Quality; January 2012. AHRQ Publication No. 11(12)-EHC075-EF. Available at www.effectivehealthcare.ahrq.gov/ckd.cfm.
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