Albuminuria May Help Predict Progressive Renal Disease

February 16, 2009 — Screening for albuminuria may help identify patients at increased risk for progressive renal disease, according to the results of a population-based cohort study reported in the February 11 Online First issue of the Journal of the American Society of Nephrology.

The amount of albuminuria was linked to a risk for renal disease. The greater the level of albuminuria, the greater was the risk for RRT and the faster the deterioration in renal function. Albuminuria with urinary albumin concentration (UAC) of 20 mg/L or more had a 58% sensitivity and a 92% specificity to identify individuals who began RRT during follow-up. Half (50%) of these individuals were not being medically treated, and 39% were not previously known to have renal impairment.

When screening was restricted to high-risk groups, such as those with known hypertension, diabetes, cardiovascular disease (CVD), and older age, the sensitivity of the test was only marginally decreased, but it failed to identify 45% of individuals with microalbuminuria and macroalbuminuria.

"Individuals with elevated levels of urinary albumin are at increased risk for RRT and accelerated loss of renal function," the study authors write. "Screening for albuminuria identifies patients at increased risk for progressive renal disease, 40 to 50% of whom were previously undiagnosed or untreated."

http://www.medscape.com/viewarticle/588350?sssdmh=dm1.432287&src=nldne