Abstract: TH-PO481

Utility of Screening for Albuminuria among US Hispanic Adults with Preserved eGFR

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 303 CKD: Epidemiology, Outcomes - Cardiovascular

Authors

  • Sarathy, Harini, UC San Francisco, San Francisco, California, United States
  • Scherzer, Rebecca, UCSF, San Francisco, California, United States
  • Shlipak, Michael, San Francisco VA Medical Center, San Francisco, California, United States
  • Lash, James P., University of Illinois at Chicago, Chicago, Illinois, United States
  • Zeng, Donglin, University of North Carolina, Chapel Hill, North Carolina, United States
  • Schneiderman, Neil, University of Miami , Coral Gables, Florida, United States
  • Peralta, Carmen A., University of California San Francisco/SFVAMC, San Francisco, California, United States
Background

In the U.S., Hispanics have higher prevalence of albuminuria and faster rates of CKD progression, compared to non-Hispanic whites. The yield of screening for albuminuria among Hispanics without a current indication to screen i.e. without diabetes, cardiovascular disease (CVD), or CKD is unknown. Current rates of blood pressure control and use of angiotensin converting enzyme inhibitors/ angiotensin II receptor blockers (ACEI/ARB) in those with albuminuria are not known.

Methods

Among 9510 participants in the Hispanic Communities Health Study/Study of Latinos (HCHS/SOL) with eGFR≥60ml/min/1.73m2 and without diabetes or CVD, we determined prevalence of albuminuria (albumin to creatinine ratio ≥30mg/g) and calculated number needed to screen (NNS), overall, and within predefined subgroups. Among those identified with albuminuria, we determined rates of blood pressure (BP)≥140/90, and use of ACEI/ARB.

Results

The median age and eGFR were 34 years (IQR 25-45) and 113 ml/min/1.73m2 (IQR 100- 123) respectively. Prevalence of albuminuria was 5.7% (95% CI 5.2%- 6.4%) resulting in NNS of 17.0 (95% CI 16.0-19.0), and NNS was lowest among those with BP≥140/90 mmHg, followed by those with BP≥130/80 mmHg. (Figure). Among Hispanics with albuminuria, rates of BP≥140/90mmHg was 23% and ranged from 8.5 to 53% with increasing age. Only 29.5% of persons with albuminuria and BP≥140/90 were on ACEI/ARB.

Conclusion

Among Hispanics without a current indication for albuminuria testing, screening for albuminuria identified opportunities to initiate and/or intensify CVD and CKD risk reduction therapies, especially persons with hypertension.

Fig 1: Number needed to screen [NNS (95%CI] to detect one case of albuminuria among Hispanic adults without diabetes or CVD and with preserved eGFR

Funding

  • NIDDK Support