Abstract: TH-PO0602
The AUDIT Study: Why Aren't We Testing More? Understanding and Resolving Low Use of the Urine Albumin-to-Creatinine Ratio in CKD
Session Information
- CKD: From Global Burden to Precision Care - Epidemiology, Demographics, Geographies, and Risk Factors
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2201 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Wittrup-Jensen, Villum, Boehringer Ingelheim International GmbH, Ingelheim am Rhein, RP, Germany
- Dent, Michael, CRA International Inc London, London, England, United Kingdom
- Patel, Bhavesh, CRA International Inc London, London, England, United Kingdom
- Pratumsuwan, Sasirasa, CRA International Inc London, London, England, United Kingdom
- Clark, Joanne Michelle, CRA International Inc London, London, England, United Kingdom
- Walters, David, Boehringer Ingelheim International GmbH, Ingelheim am Rhein, RP, Germany
Background
Chronic kidney disease (CKD) has a major impact on global health systems, with high mortality rates and substantial economic burden. Based on global and national guidelines, urine albumin creatinine ratio (UACR) testing is an integral element of diagnosis and management of CKD and should be performed at numerous points during the patient journey. Despite strong guideline endorsement, real-world utilization data suggests that UACR testing is widely under-implemented, potentially leading to underdiagnosis and inadequate management of CKD.
Methods
A targeted literature review (TLR) was conducted using predefined keywords to identify English-language peer-reviewed publications from Europe, Japan, and China authored between 2015-2025. Evidence was synthesized to assess real-world UACR utilization in populations at risk of or with CKD, as well as key drivers of underuse.
Based on insights from the TLR, a series of 1:1 interviews with physicians and patient representatives will be conducted to explore underlying reasons for underuse of UACR testing and associated consequences. Potential solutions to enable testing levels to more closely align with guidelines will be then developed via focus groups including the physicians and patient representatives.
Results
Literature reported UACR testing rates vary widely across geographies, populations (e.g., patients with type 2 diabetes vs. other risk factors), and settings of care (e.g., primary vs. specialist care). In almost all settings, UACR testing appears to be significantly underutilized, driven by a complex range of factors, including low physician awareness, systemic factors, varied perceptions of the added value of testing, workload pressures, national reimbursement restrictions, and/or lack of financial incentivization. Qualitative primary research with physicians and patients will strengthen understanding of reasons behind underutilization of testing in clinical practice. Additionally, it will offer priority solutions for increasing testing rates to optimize CKD patient care.
Conclusion
Underutilization of guideline-recommended UACR testing is driven by multiple interlinked healthcare system and physician-related factors. In-depth primary research is needed to evaluate priority factors and associated levers to increase testing, potentially meaningfully impacting the global burden of CKD.
Funding
- Commercial Support – Boehringer Ingelheim