Kidney society describes ways to eliminate wasteful tests and procedures

September 13, 2012

Earlier this year, the American Society of Nephrology (ASN), the world's leading kidney organization, joined other groups in a campaign to help health care professionals and patients avoid wasteful and sometimes harmful medical interventions. A new article in the Clinical Journal of the American Society of Nephrology (CJASN) outlines the ASN's top five recommendations for the campaign and the rationale behind them. Following these recommendations would lower costs and lead to better care for patients with kidney disease.

Unnecessary or redundant tests and procedures account for nearly one third of the medical care delivered in the United States. As part of the Choosing Wisely® campaign, nine leading national medical specialty societies each created lists of five common, but not always necessary, tests or procedures in their fields that patients and physicians should question and discuss, taking into consideration patients' preferences, needs, and overall health goals as well as the potential benefits and harms of different options.

In their CJASN article, Amy Williams, MD (Mayo Clinic) and her colleagues reveal how ASN identified its five recommendations and describe the background evidence supporting them. Each of the ASN's 10 Advisory Groups submitted recommendations, and the ASN Quality and Patient Safety Task Force, chaired by Dr. Williams, selected five based on relevance and importance to individuals with kidney disease. The ASN public policy board and council unanimously approved the final list, which includes the following: 1. Do not perform routine cancer screening for with limited without signs or symptoms; 2. Do not administer erythropoiesis stimulating agents—drugs that are commonly used to treat anemia—to (CKD) patients with ≥10 g/dL without symptoms of anemia; 3. Avoid nonsteroidal anti-inflammatory drugs in individuals with hypertension, heart failure, or CKD; 4. Do not place peripherally inserted central catheters—which allows access to the blood for prolonged treatments such as long chemotherapy regimens and extended antibiotic therapy—in stage 3-5 CKD patients without consulting a kidney specialist; 5. Do not initiate long-term dialysis without ensuring a shared decision-making process between patients, their families, and their physicians.

"The goals of the Choosing Wisely campaign are aligned with the ASN's goals: to deliver safe evidence-based individualized care to all patients with kidney disease. By improving the value of the care we deliver to people with kidney disease, we will improve outcomes and decrease unnecessary healthcare costs and potentially decrease harm," said Williams.

More information: The article, entitled "Critical and Honest Conversations: The Evidence Behind the "Choosing Wisely Campaign" Recommendations by the American Society of Nephrology," will appear online on September 13, 2012, doi: 10.2215/CJN.04970512

Related Stories

US medical students are rejecting kidney careers

May 5, 2011

Kidney disease affects 1 in 9 US adults, and by 2020 more than 750,000 Americans will be on dialysis or awaiting kidney transplant. Despite this growing health problem, every year fewer US medical students adopt nephrology ...

Recommended for you

Experimental MERS vaccine shows promise in animal studies

July 28, 2015

A two-step regimen of experimental vaccines against Middle East respiratory syndrome (MERS) prompted immune responses in mice and rhesus macaques, report National Institutes of Health scientists who designed the vaccines. ...

Can social isolation fuel epidemics?

July 21, 2015

Conventional wisdom has it that the more people stay within their own social groups and avoid others, the less likely it is small disease outbreaks turn into full-blown epidemics. But the conventional wisdom is wrong, according ...

Lack of knowledge on animal disease leaves humans at risk

July 20, 2015

Researchers from the University of Sydney have painted the most detailed picture to date of major infectious diseases shared between wildlife and livestock, and found a huge gap in knowledge about diseases which could spread ...

IBD genetically similar in Europeans and non-Europeans

July 20, 2015

The first genetic study of inflammatory bowel disease (IBD) to include individuals from diverse populations has shown that the regions of the genome underlying the disease are consistent around the world. This study, conducted ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.