Kidney Week

Abstract: TH-PO0972

Initial Testing for Albuminuria and Hematuria in Young Adults with New-Onset CKD

Session Information

• Diversity and Equity in Kidney Health
  November 06, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Diversity and Equity in Kidney Health

• 900 Diversity and Equity in Kidney Health

Authors

• Gerber, Anisha, University of Virginia, Charlottesville, Virginia, United States

Anisha Gerber, MD

• Yu, Wei, University of Virginia, Charlottesville, Virginia, United States

Wei Yu, MA, MS

• Cheung, Alfred K., The University of Utah School of Medicine, Salt Lake City, Utah, United States

Alfred K. Cheung, MD

• Kelley, Alan Taylor, University of Utah Health, Salt Lake City, Utah, United States

Alan Taylor Kelley, MD, MPH

• Greene, Tom, The University of Utah School of Medicine, Salt Lake City, Utah, United States

Tom Greene, PhD

• Heng, Fei, University of North Florida, Jacksonville, Florida, United States

Fei Heng

• Nee, Robert, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States

Robert Nee, MD, FASN

• Norris, Keith C., University of California Los Angeles, Los Angeles, California, United States

Keith C. Norris, MD, PhD

• Yan, Guofen, University of Virginia, Charlottesville, Virginia, United States

Guofen Yan, PhD

• Scialla, Julia J., University of Virginia, Charlottesville, Virginia, United States

Julia J. Scialla, MD, FASN

Background

Young adults (YAs) with CKD experience faster disease progression than older adults (OAs). Our prior work shows that age disparities are more pronounced in minoritized racial/ethnic groups. Inadequate assessment in YAs for albuminuria and hematuria, which may indicate high-risk glomerular disease, could be one explanation. Here we assess associations among age, race, and completion of urine albumin-to-creatinine ratio (UACR) and urinalysis (UA) in adults with new onset CKD.

Methods

We included adults aged 18-65 years with new onset CKD in the national Veterans Health Administration between 2005-2015. CKD was defined as 2 outpatient measures of estimated glomerular filtration rate (eGFR) <60 ml/min/1.73m2 ≥90 days apart. We estimated odds of UACR and UA within 3 years of CKD onset, comparing YAs aged 18-44 to OAs aged 45-65 and adjusting for diabetes, hypertension, sex, race/ethnicity, and calendar year. We then stratified by race/ethnicity.

Results

The study included 114,503 OAs and 1,553 YAs: 7% female, 70% Non-Hispanic White, 21% Non-Hispanic Black, 5% Hispanic, and 4% other. Mean eGFR at CKD onset was about 51 (SD 8) ml/min/1.73m2. Overall, 24% completed UACR and UA, 37% UACR only, and 64% UA only. Compared to OAs, YAs had 27% higher adjusted odds of UA completion but 14% lower adjusted odds of UACR completion (Figure 1). Within groups, Black YAs had 43% higher adjusted odds of UA completion, and Hispanic YAs had 51% lower adjusted odds of UACR completion compared to OAs of concordant race/ethnicity. No association was found between age and completing both tests.

Conclusion

Compared to OAs, YAs had lower odds of completing UACR, but higher odds of completing UA, suggesting age-related differences in practice patterns. Strength of associations varied by race/ethnicity. Efforts to improve timely assessment for glomerular disease are warranted, as the overall rate of completing both tests within 3 years of CKD onset was low.

Figure 1

Funding

• NIDDK Support

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.20259d2pfg0r