Estimated Prevalence and Testing for Albuminuria in US Adults at Risk for Chronic Kidney Disease
Authors' conclusion
In this cohort study of patients with hypertension or diabetes, it was estimated that approximately two-thirds of patients with albuminuria were undetected due to lack of testing. These results suggest that improving detection of CKD with albuminuria testing represents a substantial opportunity to optimize care delivery for reducing CKD progression and cardiovascular complications.
Study context
- Population
- US adults with hypertension or diabetes, active outpatients in Optum deidentified electronic health record (EHR) data set; mean age 60.3 years, 96.6% hypertension, 26.2% diabetesEHR population
- Participants
- 192,108 adults
- Exposure
- Albuminuria testing vs no testing
- Testedn = 33,629
- Untestedn = 158,479reference
- Outcome
- Prevalence of albuminuria (urine albumin-creatinine ratio ≥30 mg/g) among tested and untested patients
- Follow-up
- January 1, 2017, to December 31, 2018
Methodological detailsNational Health and Nutrition Examination Surveys (NHANES)-derived logistic regression model applied to EHR data
- NHANES-derived logistic regression model applied to EHR data
Main finding
As reported in the abstract
Albuminuria prevalence
- Projected population with albuminuria who had been tested
- 35.2% (11 525 of 32 756)
Observational data: associations, not effects.
Further findings
| Outcome | OR (95% CI) | |
|---|---|---|
| CKD therapies within subsequent year, by albuminuria testing (adjusted)Testedvs UntestedACEi or ARB treatment · multivariable logistic regression | 2.39 (2.32–2.46) | |
| CKD therapies within subsequent year, by albuminuria testing (adjusted)Testedvs UntestedSGLT2i treatment · multivariable logistic regression | 8.22 (7.56–8.94) | |
| CKD therapies within subsequent year, by albuminuria testing (adjusted)Testedvs UntestedBP controlled to <140/90 mm Hg · multivariable logistic regression | 1.20 (1.16–1.23) | |
| 0.10.31310Odds ratio (log scale) |
Original publication
Estimated Prevalence and Testing for Albuminuria in US Adults at Risk for Chronic Kidney Disease. JAMA Netw Open. Published 3 July 2023. doi:10.
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