The American Kidney Fund (AKF) recently submitted comments on the U.S. Preventive Services Task Force's (USPSTF) draft research plan on a chronic kidney disease (CKD) screening recommendation. AKF commended the USPSTF for the draft research plan and voiced its overall support for it. We also made recommendations on providing clearer definitions for terms such as "screening," "harms" and "quality of life;" as well as expanding the researched population to include subpopulations of people under the age of 18 and including additional patient-centered outcomes and broader health care system outcomes in the USPSTF's evidence review. Examining additional outcomes such as referral time to nephrology, referral time to transplant, quality of dialysis start (e.g., fistula placement, home dialysis initiation) and the potential impact of increased CKD screening on the system of care will provide a more comprehensive assessment of the benefits and harms of a CKD screening recommendation.
The USPSTF is an independent, volunteer panel of national experts that makes evidence-based recommendations on effective ways to prevent disease and prolong life. As part of its recommendation development process, the USPSTF creates a draft research plan to guide the systematic review of the evidence on a potential screening recommendation. The draft research plan consists of an analytic framework, key questions, and a literature search strategy or research approach. The next step in the process is for USPSTF to finalize and implement its research plan and later release a draft recommendation and draft evidence review, which will be the next opportunity for public comment. Then the USPSTF will release a final recommendation and evidence summary.
AKF is pleased to see the USPSTF's efforts on a CKD screening. In August 2022, AKF submitted a letter urging the USPSTF to develop a CKD screening recommendation due to the growing number of people who experience kidney failure and need dialysis or transplantation, the health disparities associated with kidney disease and the need for a clinical assessment tool for use by primary care physicians and other providers when screening for CKD. The last time the USPSTF considered kidney screening guidelines was 2012 and much has changed since then. For example, there are at least two classes of drugs today to slow the progression of CKD that did not exist in 2012 (SGLT2 inhibitors and GLP-1 receptor agonists). We look forward to the next steps in the process as the USPSTF works on a CKD screening recommendation, which would be a critical step in preventing and slowing the progression of kidney disease for millions of Americans.