Abstract: TH-PO990
Micral-Test® Strip to Detect Albuminuria Among Patients with CKD Risk Factors
Session Information
- CKD Epidemiology, Risk Factors, Prevention - I
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Ooi, Xi Yan, Tan Tock Seng Hospital, Singapore, Singapore
- Weng, Wanting, Tan Tock Seng Hospital, Singapore, Singapore
- Yeo, See Cheng, Tan Tock Seng Hospital, Singapore, Singapore
Background
CKD is often asymptomatic and remains undiagnosed in its early stages. Screening and early identification of CKD allows implementation of treatment to delay progression and prevent adverse outcomes. To improve screening uptake and decrease screening cost in primary care,we piloted a 2 stage-screening strategy:pre-screening using microalbuminuria (Micral-Test®) strips, and confirmatory laboratory testing for positive results. In this study, we examined the testing characteristics of this screening strategy.
Methods
We provided Micral-Test® strips to 15 General Practitioners in Singapore. Individuals with these risk factors were offered screening:diabetes mellitus(DM), hypertension(HT), BMI>27.5kg/m2, age>60 years, cardiovascular/cerebrovascular disease, family history of kidney disease or smoking history. Patients with positive test were offered a specialist review for confirmation of albuminuria. We calculated a minimum sample size of 97 is needed to achieve 10% margin error and 95% confidence interval.
Results
209 patients were recruited between April 2022 to April 2023; 72% had HT and 23% had DM. 111(53%) were screen positive and 43% of screen-positive subjects did not follow up with confirmatory testing. Of the 63 patients who proceeded with a confirmatory urine albumin-creatinine ratio test, 37(58.7%) had confirmed albuminuria; 29 moderately increased albuminuria and 8 severely increased albuminuria. The positive predictive value (PPV) of Micral-test was highest in patients with DM, with or without other comorbidities, and is relatively low in patients without any comorbidities(age>60 years only).
Conclusion
Majority of patients with risk factors for CKD have undiagnosed albuminuria. Our study suggests that Micral-test® strip can be used as an effective screening tool for albuminuria especially in patients with DM. There remains a large proportion of patients with screen positive results that declined further follow-up; further education and screening strategy should target this group for better CKD identification.
Test characteristics in different subpopulations
| Population | Screen positive(%) | PPV(%) |
| All | 53.1 | 58.7 |
| Diabetes Mellitus | 77.6 | 80.8 |
| Hypertension | 53.0 | 58.8 |
| Diabetes mellitus, hypertension and age>60 years old | 74.1 | 77.8 |
| Age>60 years old only | 33.3 | 0 |
Funding
- Commercial Support – AstraZeneca