Focus on microalbuminuria to improve cardiac and renal protection

With the recent attention to diagnose earlier stages of chronic kidney diseases (CKD), most attention focuses on screening for an impaired estimated glomerular filtration rate (eGFR), i.e. CKD stages 3-5. Less attention is given to the impact of the urinary leakage of albumin. Its presence is not taken into account in the definition of stages 3-5, but only required to diagnose stages 1 and 2. As in stages 1 and 2 CKD, eGFR is not or only modestly impaired, these stages are generally considered to have a relatively better prognosis. In this review, we will show evidence that screening for albuminuria may be of great benefit, not only as an argument to start treatment to prevent progressive renal function loss, but also to prevent cardiovascular events.