A new definition of chronic kidney disease labels about 1 in every 8 adults — half of Americans over 70 years of age — as having the condition. Yet low rates of kidney failure suggest many diagnosed with the condition will never progress to severe disease.
In a new report in the British Medical Journal BMJ.com, Ray Moynihan and colleagues argue the new definition will lead to needless overdiagnosis and call for a re-examination of the new label. They also urge clinicians to be cautious about labeling patients, particularly seniors.
"It is in everyone's interest to find the best way to maximize prevention of kidney disease and its consequences while minimizing the risks and costs of overdiagnosis," they argue.
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In 2002, a new framework for defining and classifying "chronic kidney disease" was proposed, classifying any patient with kidney damage or decreased kidney function for three months or more as having the condition. The definition was updated in 2012.
But some doctors have raised concerns because the adoption of this definition has resulted in almost 14 percent of Americans being diagnosed with chronic kidney disease — far more than the 1.7 percent diagnosed prior to 2002.
Advocates of the new definition say early detection can help prevent the progression of kidney disease, but Moynihan and other critics note suggest many of those diagnosed will never progress to serious disease.
They argue that the benefits, harms, and costs of testing, monitoring, and treating the increased number of people being identified as having chronic kidney disease "need to be established by prospective studies."
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