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Abstract: TH-PO1068

Targeted Screening for Albuminuria in Diabetes Mellitus: A Strategy Worth Revisiting?

Session Information

Category: CKD (Non-Dialysis)

  • 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Bragg-Gresham, Jennifer L., University of Michigan, Ann Arbor, Michigan, United States
  • Gillespie, Brenda W., University of Michigan, Ann Arbor, Michigan, United States
  • Herman, William H., University of Michigan, Ann Arbor, Michigan, United States
  • Powe, Neil R., Priscilla Chan and Mark Zuckerberg San Francisco Gen Hosp & UCSF, San Francisco, California, United States
  • Banerjee, Tanushree, San Francisco General Hospital , San Francisco, California, United States
  • Harding, Jessica L., Centers for Disease Control and Prevention, Atlanta, Georgia, United States
  • Saydah, Sharon, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
  • Saran, Rajiv, University of Michigan, Ann Arbor, Michigan, United States
Background

Albuminuria is a risk factor for cardiovascular disease (CVD), kidney disease and their progression. Current guidelines recommend screening all people with diabetes (DM) for albuminuria to identify those at greatest risk. However, only 40% of DM patients currently receive albuminuria screening. We assessed patient characteristics associated with albuminuria in people with DM.

Methods

Associations between individual characteristics (self-reported and biometric) and albuminuria (albumin-to-creatinine ratio of ≥30 mg/g) were assessed among 4,222 individuals with DM (self-reported, or HbA1c > 7%), aged 20+ years, from the National Health and Nutrition Examination Survey (1999-2014), using multivariable survey-weighted logistic regression. We assessed model predictive ability using Harrell’s c-statistic.

Results

Mean age was 59 (range 20-85+) years and the prevalence of albuminuria was 30.3% (95% CI: 28.7-31.8%). Significant predictors of albuminuria are shown in the Table below (c-statistic = 0.67, indicating moderate prediction of albuminuria).

Conclusion

In this study several self-reported and biometric characteristics were independently associated with albuminuria and collectively, moderately predictive of albuminuria. Targeted screening of people with DM at high risk for albuminuria may improve albuminuria detection and in turn, may help with prevention or management of CVD and kidney disease.

Adjusted odds ratios and 95% confidence intervals for the association between characteristics and albuminuria in people with diabetes

Funding

  • Other U.S. Government Support