Proteinuria Screening in the Primary Care Office: A Review and a Quality Improvement Project

Proteinuria is associated with substantial cardiovascular and renal morbidity, mortality, and increased rates of hospitalization. It serves as an early indicator of chronic kidney disease (CKD).

This review examined the relationship between proteinuria, CKD, and major adverse cardiovascular events, summarized evidence-based therapies, identified gaps in screening, and presented a quality improvement (QI) project from Kaiser Permanente East Bay.

The authors conducted a literature review and a QI project using the Kaiser Permanente national CKD staging algorithm. Patients aged 18-75 years old with CKD stages 3 or 4 were identified and categorized by comorbidities. Screening rates were analyzed.

All patients with diabetes and CKD 3 and 4 received proteinuria screening. Screening rates were lower among patients with hypertension and without diabetes.

Early detection and intervention can reduce major adverse cardiovascular events and CKD progression. The QI project highlights effective workflows and the need to expand screening protocols to broader populations.