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Screening diabetic patients for microalbuminuria
J C Konen1, L G Curtis, Z K Shihabi
1Department of Family and Community Medicine, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina.
Abstract:
Abnormal rates of urinary albumin excretion have been shown to predict the development of nephropathy and may signal atherosclerotic disease in diabetic patients. This study demonstrated the feasibility of measuring microalbuminuria in diabetic patients from a large family practice population. Although only one half of the 473 diabetic patients offered free screening took advantage of the testing, those participating did not differ in terms of sex, race, type of diabetes, mean age, systolic blood pressure, and fasting blood glucose levels from those not electing to participate. Over 40% of those screened had abnormally elevated albumin excretion rates as defined as greater than 0.02 g of albumin per gram of creatinine. Those participating in the screening perceived the process as useful and were able to comply with directions for overnight urine collection. Results show that screening for microalbuminuria in diabetic patients cared for by family physicians is feasible, simple, and inexpensive. Interventions to slow or reverse the progression of abnormal microalbuminuria and future risk for nephropathy in those with diabetes are underway.
Insights
Screening for microalbuminuria, an early sign of kidney disease in diabetes, is feasible in family practice settings. Over 40% of screened diabetic patients showed elevated albumin excretion, indicating a high prevalence.
Area of Science:
- Nephrology
- Endocrinology
- Family Medicine
Background:
- Abnormal urinary albumin excretion predicts diabetic nephropathy and atherosclerotic disease.
- Early detection of microalbuminuria is crucial for managing diabetic complications.
Purpose of the Study:
- To assess the feasibility of measuring microalbuminuria in a large family practice population of diabetic patients.
- To determine the prevalence of elevated albumin excretion rates in this cohort.
Main Methods:
- A free screening for microalbuminuria was offered to 473 diabetic patients.
- Urine samples were collected for albumin-to-creatinine ratio measurement.
- Demographic and clinical data were compared between participants and non-participants.
Main Results:
- Approximately 50% of eligible diabetic patients participated in the screening.
- Participating patients were representative of the overall diabetic population in the practice.
- Over 40% of screened patients exhibited abnormally elevated albumin excretion rates (>0.02 g/g creatinine).
- Participants found the screening process useful and complied with overnight urine collection instructions.
Conclusions:
- Screening for microalbuminuria in diabetic patients within family practice is feasible, simple, and cost-effective.
- A significant proportion of diabetic patients in primary care settings have elevated albuminuria, highlighting the need for screening.
- Further interventions are being developed to manage abnormal microalbuminuria and reduce nephropathy risk.