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Kidney Week

Abstract: PO0506

Urine Albumin and Serum Creatinine Dual Testing in US Veterans: Trends and Associations with Subspecialty Care

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Bhave, Nicole M., University of Michigan, Ann Arbor, Michigan, United States
  • Han, Yun, University of Michigan, Ann Arbor, Michigan, United States
  • Steffick, Diane, University of Michigan, Ann Arbor, Michigan, United States
  • Bragg-Gresham, Jennifer L., University of Michigan, Ann Arbor, Michigan, United States
  • Zivin, Kara, University of Michigan, Ann Arbor, Michigan, United States
  • Burrows, Nilka Rios, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
  • Pavkov, Meda E., Centers for Disease Control and Prevention, Atlanta, Georgia, United States
  • Tuot, Delphine S., University of California San Francisco, San Francisco, California, United States
  • Powe, Neil R., University of California San Francisco, San Francisco, California, United States
  • Saran, Rajiv, University of Michigan, Ann Arbor, Michigan, United States
Background

Urine albumin and serum creatinine (SCr) help define chronic kidney disease (CKD). Despite the fact that urine albumin and SCr are multiplicatively associated with cardiovascular and all-cause mortality, dual testing remains limited. We sought to characterize trends in dual testing in all veterans and those seen by nephrologists.

Methods

We used Veterans Health Administration (VA) data (2009-18). VA patients with any inpatient or outpatient visit in a given calendar year were included. Time trend of dual testing and patient characteristics including age, sex, race, hypertension, diabetes, CKD, and cardiovascular diseases (CVD) were noted.

Results

The study population included 58,508,942 patients (90.3% male). Overall, 12.5% of VA patients had both Scr and urine albumin testing in 2009 as compared with 18.6% in 2018 (Fig.A, ptrend<0.001). Among patients seen by nephrologists, 30.1% had both SCr and urine albumin testing in 2009, increasing to 43.3% in 2018 (Fig.B, ptrend<0.001). Compared to VA patients with SCr testing only, those with both SCr and urine albumin testing were older, more likely to be male, and more likely to have diabetes, hypertension, and CKD, but less likely to have CVD (p<0.001).

Conclusion

Dual SCr and urine albumin testing among VA nephrology patients is more common than among all VA patients and has increased over time, However, in a given year, less than half of nephrology patients undergo dual testing. Efforts to encourage screening for albuminuria among patients at high risk for CKD and CVD might be considered.

Funding

  • Other U.S. Government Support