BACKGROUND: A number of screening criteria, applied either at a single point in time or serially, can be used for the purpose of identifying individuals at risk of end-stage renal disease (ESRD). This study focused on two such criteria measured on a single occasion, proteinuria and renal insufficiency, and examined their prevalence in a sample representative of the adult U.S. non-institutionalized population. Such knowledge guides the utility of population screening to prevent ESRD. METHODS: The prevalence of albuminuria (microalbuminuria and macroalbuminuria from a random urine albumin-to-creatinine ratio) and renal insufficiency [glomerular filtration rate (GFR) estimated from serum creatinine] was determined in different age categories in various adult screening groups in the cross-sectional Third National Health and Nutrition Examination Survey (NHANES III). RESULTS: A total of 14,622 adult participants were included in the analysis. In the general population, 8.3% and 1.0% of participants demonstrated microalbuminuria and macroalbuminuria, respectively. To identify one case of albuminuria, one would need to screen three persons with diabetes mellitus, seven non-diabetic hypertensive persons, or six persons over the age of 60. When albuminuria and renal insufficiency were considered together, it was clear that these tests were identifying different segments of the population; 37% of participants with a GFR less than 30 mL/min/1.73 m2 demonstrated no albuminuria. Non-albuminuric renal insufficiency was most evident in the ages of 60 to 79; 34% of diabetics, and 63% of non-diabetic hypertensives with a GFR less than 30 mL/min/1.73 m2 demonstrated no albuminuria. CONCLUSIONS: Albuminuria is prevalent, and when considered together, screening tests of albuminuria and renal insufficiency measured on a single occasion identify different segments of the population. The prevalence of albuminuria and renal insufficiency in populations of interest should be considered, as this knowledge has implications for the effectiveness of screening.
BACKGROUND: A number of screening criteria, applied either at a single point in time or serially, can be used for the purpose of identifying individuals at risk of end-stage renal disease (ESRD). This study focused on two such criteria measured on a single occasion, proteinuria and renal insufficiency, and examined their prevalence in a sample representative of the adult U.S. non-institutionalized population. Such knowledge guides the utility of population screening to prevent ESRD. METHODS: The prevalence of albuminuria (microalbuminuria and macroalbuminuria from a random urine albumin-to-creatinine ratio) and renal insufficiency [glomerular filtration rate (GFR) estimated from serum creatinine] was determined in different age categories in various adult screening groups in the cross-sectional Third National Health and Nutrition Examination Survey (NHANES III). RESULTS: A total of 14,622 adult participants were included in the analysis. In the general population, 8.3% and 1.0% of participants demonstrated microalbuminuria and macroalbuminuria, respectively. To identify one case of albuminuria, one would need to screen three persons with diabetes mellitus, seven non-diabetic hypertensivepersons, or six persons over the age of 60. When albuminuria and renal insufficiency were considered together, it was clear that these tests were identifying different segments of the population; 37% of participants with a GFR less than 30 mL/min/1.73 m2 demonstrated no albuminuria. Non-albuminuric renal insufficiency was most evident in the ages of 60 to 79; 34% of diabetics, and 63% of non-diabetic hypertensives with a GFR less than 30 mL/min/1.73 m2 demonstrated no albuminuria. CONCLUSIONS:Albuminuria is prevalent, and when considered together, screening tests of albuminuria and renal insufficiency measured on a single occasion identify different segments of the population. The prevalence of albuminuria and renal insufficiency in populations of interest should be considered, as this knowledge has implications for the effectiveness of screening.
Authors: Joshua I Barzilay; James F Lovato; Anne M Murray; Jeff Williamson; Faramaz Ismail-Beigi; Diane Karl; Vasilios Papademetriou; Lenore J Launer Journal: Clin J Am Soc Nephrol Date: 2013-08-29 Impact factor: 8.237
Authors: Roland E Schmieder; Johannes F E Mann; Helmut Schumacher; Peggy Gao; Giuseppe Mancia; Michael A Weber; Matthew McQueen; Teo Koon; Salim Yusuf Journal: J Am Soc Nephrol Date: 2011-06-30 Impact factor: 10.121
Authors: Dena E Rifkin; Ronit Katz; Michel Chonchol; Linda F Fried; Jie Cao; Ian H de Boer; David S Siscovick; Michael G Shlipak; Mark J Sarnak Journal: Nephrol Dial Transplant Date: 2009-12-15 Impact factor: 5.992
Authors: Ewa Król; Bolesław Rutkowski; Piotr Czarniak; Ewa Kraszewska; Sławomir Lizakowski; Radosław Szubert; Stanisław Czekalski; Władysław Sułowicz; Andrzej Wiecek Journal: Am J Nephrol Date: 2008-09-23 Impact factor: 3.754
Authors: Toshiharu Ninomiya; Vlado Perkovic; Bastiaan E de Galan; Sophia Zoungas; Avinesh Pillai; Meg Jardine; Anushka Patel; Alan Cass; Bruce Neal; Neil Poulter; Carl-Erik Mogensen; Mark Cooper; Michel Marre; Bryan Williams; Pavel Hamet; Giuseppe Mancia; Mark Woodward; Stephen Macmahon; John Chalmers Journal: J Am Soc Nephrol Date: 2009-05-14 Impact factor: 10.121
Authors: Meda E Pavkov; Clinton C Mason; Peter H Bennett; Jeffrey M Curtis; William C Knowler; Robert G Nelson Journal: Diabetes Care Date: 2009-07-10 Impact factor: 17.152
Authors: Konstantinos Tziomalos; Emmanuel S Ganotakis; Irene F Gazi; Devaki R Nair; Dimitri P Mikhailidis Journal: Open Cardiovasc Med J Date: 2009-06-16