Lack of Regular Albuminuria Screening Leaves CKD Undetected

Despite similar risk for albuminuria with diabetes, albumin-to-creatinine ratio screening in patients with hypertension remains very low



MONDAY, Sept. 13, 2021 (HealthDay News) — Albuminuria testing is underutilized in people with hypertension or diabetes, according to a study published in the September issue of Hypertension.

Jung-Im Shin, M.D., from the Johns Hopkins Bloomberg School of Public Health in Baltimore, and colleagues used data from 1,344,594 adults with diabetes and 2,334,461 nondiabetic adults with hypertension from the chronic kidney disease Prognosis Consortium to estimate the prevalence and incidence of albumin-to-creatinine ratio (ACR) ≥30 mg/g.

The researchers found that the ACR screening rate was 35.1 percent in individuals with diabetes and 4.1 percent in those with hypertension, but screening was largely unrelated to the predicted risk for prevalent albuminuria. ACR ≥30 mg/g across cohorts had a median prevalence of 32.1 percent with the diabetes cohort and 21.8 percent with hypertension. There was an association between higher systolic blood pressure and a higher prevalence of albuminuria (odds ratio [OR] per 20 mm Hg in diabetes, 1.50; in hypertension, 1.36). Due to a lack of screening, the ratio of undetected to detected ACR ≥30 mg/g was 1.8 in diabetes and 19.5 in hypertension. The median five-year incidence of ACR ≥30 mg/g across cohorts starting with ACR <30 mg/g was 23.9 percent with diabetes and 21.7 percent with hypertension.

“Our findings suggest that regular albuminuria screening should be emphasized to enable early detection of chronic kidney disease and initiation of treatment with cardiovascular and renal benefits,” the authors write.

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