Screening for Albuminuria at the First Line for Early Identification of CKD

General Practitioners Research Institute141 enrolled

Overview

Early detection of kidney disease

Early detection and appropriate treatment of kidney disease is important as this may prevent future cardiovascular complications and end-organ damage more effectively than intervention in more advanced stages of disease. There is a well-established relationship between albuminuria and renal- and cardiovascular disease. Elevated albuminuria has a relatively high prevalence in the general population (5-9%). The prevalence of albuminuria is even higher in high-risk patients with diabetes Mellitus, hypertension, obesity, cardiovascular disease and lipid disorders. Adequate treatment of albuminuria, preferable at early stages can prevent both cardiovascular and renal disease progression. However, scarce epidemiological data show that albuminuria measurements are only conducted in a minority of individuals and disease recognition is suboptimal, even in high-risk groups. The current study aims to evaluate if and how early identification of chronic kidney disease by targeted screening of albuminuria levels is feasible in primary care (pharmacies and general practitioners) to optimally discover and treat patients with elevated albuminuria.

Study Type

OBSERVATIONAL

Enrollment

141

Conditions

Chronic Kidney Diseases Albuminuria

Interventions

Albuminuria testDIAGNOSTIC_TEST

During participation, subjects are asked to collect one or more urine samples for albuminuria determination.

HbA1c testDIAGNOSTIC_TEST

During the screening visit, HbA1c will be measured with a point-of-care test (Affinion HbA1c, Abbott).

Creatinine testDIAGNOSTIC_TEST

During the screening visit, creatinine will be measured with a point-of-care test (i-STAT Alinity handheld analyser, Abbott).

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Diabetes Mellitus (diagnosis or prescription for the disease based on the NHG guidelines) * Adipositas (diagnosis) * Hypertension (diagnosis or prescription for the disease based on the NHG guidelines) * Cardiovascular disease (diagnosis, specified in protocol section 5.2.2) * Lipid disorder (diagnosis or prescription for the disease based on the NHG guidelines) Exclusion Criteria: * Inability to understand and sign the informed consent form * Pregnancy

Locations (1)

General Practitioners Research Institute

Groningen, Netherlands

Outcomes

Primary Outcomes

The prevalence of elevated albuminuria

defined as a confirmed urinary albumin creatinine ratio (UACR) ≥ 3.0 mg/mmol.

Time frame: 1-2 weeks after invitation

Secondary Outcomes

The prevalence of unknown elevated albuminuria

defined as elevated albuminuria not reported by the subject or previously recorded in electronic medical records of the subjects' general practice or pharmacy.

Time frame: through study completion, an average of 5 weeks

Average costs per subject

by screening for albuminuria via pharmacies versus general practitioners.

Time frame: through study completion, an average of 5 weeks

the proportion of invited subjects that was identified as having hidden kidney disease

by screening for albuminuria via pharmacies versus general practitioners.

Time frame: through study completion, an average of 5 weeks

Data from ClinicalTrials.gov

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