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A population-based screening for microalbuminuria among relatives of CKD patients: the Kidney Evaluation and
Aminu K Bello1, Jean Peters, Jeremy Wight
1Sheffield Kidney Institute, The University of Sheffield, Sheffield, UK.
Insights
Relatives of chronic kidney disease (CKD) patients show higher microalbuminuria prevalence. This study highlights family history of CKD as a significant risk factor, suggesting targeted screening for at-risk populations.
Area of Science:
- Nephrology
- Cardiovascular Medicine
- Public Health
Background:
- Microalbuminuria screening aids in early detection of cardiovascular disease and chronic kidney disease (CKD).
- While established for diabetic and hypertensive patients, its utility in relatives of CKD patients remains under-explored, particularly in the UK.
- Family history of CKD is a potential, uninvestigated risk factor for microalbuminuria.
Purpose of the Study:
- To evaluate the prevalence of microalbuminuria in relatives of CKD patients.
- To compare this prevalence with a matched control group from the general population.
- To identify determinants of microalbuminuria in individuals with a family history of CKD.
Main Methods:
- A cross-sectional study was conducted in Sheffield, England.
- 274 relatives of CKD patients were compared with an age- and sex-matched general population control group.
- Microalbuminuria was measured using immunonephelometry via albumin-creatinine ratio; data on demographics, lifestyle, and medical/family history were collected.
Main Results:
- The prevalence of microalbuminuria was significantly higher (9.5%) in relatives of CKD patients compared to the control group (1.4%; P = 0.001).
- Independent predictors of microalbuminuria included family history of diabetes (OR, 2.88), obesity (OR, 3.29), and family history of CKD (OR, 6.96).
- These findings indicate a heightened risk within this specific population group.
Conclusions:
- Relatives of CKD patients exhibit a greater prevalence of microalbuminuria than the general population.
- Family history of CKD is a significant determinant of microalbuminuria.
- Longitudinal studies are needed to ascertain the prognostic value of microalbuminuria in this at-risk group.
Background:
Microalbuminuria has been used to detect subjects at risk of cardiovascular disease and chronic kidney disease (CKD) in patients with diabetes, those with hypertension, and the general population. However, relatives of patients with CKD have not been investigated for microalbuminuria in the United Kingdom.
Study Design:
A cross-sectional study evaluating the prevalence of microalbuminuria in relatives of patients with CKD compared with the general population of Sheffield, England.
Setting & Participants:
Participants in the Kidney Evaluation and Awareness Program in Sheffield, a population-based screening program for microalbuminuria. 274 relatives of patients with CKD were studied and compared with an age- and sex-matched control group from the general population.
Predictor:
Family history of CKD.
Measurement & Outcomes:
Screening tools included a questionnaire collating information for demographics, lifestyle, and medical and family history of diabetes, hypertension, and CKD. Urine samples were collected for microalbuminuria estimation. Microalbuminuria measurements were obtained by using immunonephelometry. Microalbuminuria thresholds were defined using albumin-creatinine ratio.
Results:
The prevalence of microalbuminuria was 9.5% in those with a family history of CKD. This was significantly greater than the prevalence of 1.4% in the age- and sex-matched control group with no family history of CKD (P = 0.001). Independent determinants of microalbuminuria in the study population in an adjusted logistic regression model were family history of diabetes (odds ratio [OR], 2.88; 95% confidence interval, 1.17 to 7.04), obesity (OR, 3.29; 95% confidence interval, 1.61 to 6.69), and family history of CKD (OR, 6.96; 95% confidence interval, 3.48 to 13.92).
Limitations:
Cross-sectional snapshot analysis, microalbuminuria measured once.
Conclusions:
The prevalence of microalbuminuria in relatives of patients with CKD is greater than in an age- and sex-matched control group from the general population. The prognostic value of microalbuminuria in this category of at-risk population remains to be determined in longitudinal studies.
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