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Medical News & Perspectives
December 11, 2013

Nephrologists Question ACP’s Kidney Disease Guidelines

JAMA. 2013;310(22):2387-2388. doi:10.1001/jama.2013.282671

Elements of new guidelines on screening, monitoring, and treatment of chronic kidney disease released October 22 by the American College of Physicians (ACP) are sparking criticisms by some members of the nephrology community, who say the guidance rejects some practices that benefit patients.

The progressive loss of kidney function over time that characterizes chronic kidney disease affects about 26 million adults in the United States. Disease severity is divided into 5 stages based on glomerular filtration rate (GFR), estimated from serum creatinine as a measure of kidney function, and albuminuria, a marker of kidney damage from cause. People with stage 1 to 3 chronic kidney disease have normal to moderately reduced kidney function; individuals with stage 4 of the disease have severely reduced kidney function; and those with stage 5 have very severe disease, known as end-stage kidney failure.