Kidney Week

Abstract: SA-PO0449

Improving CKD Screening for Patients with Diabetes in Primary Care Using Point-of-Care Urine Albumin-to-Creatinine Ratio Testing

Session Information

• CKM: Clinical - Screening, Population Management, Care Disparities, and Patient-Centered Outcomes
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Cardiovascular-Kidney-Metabolic Health

• 602 Cardiovascular-Kidney-Metabolic Health: Clinical

Authors

• Shiplett, Alex, OhioHealth, Columbus, Ohio, United States

Alex Shiplett, MD

• Barlow, Mariah, OhioHealth, Columbus, Ohio, United States

Mariah Barlow, MD

• Attia, Karim T., OhioHealth, Columbus, Ohio, United States

Karim T. Attia, MD

• Doty, Sara, OhioHealth, Columbus, Ohio, United States

Sara Doty

Background

The American Diabetes Association and Kidney Disease: Improving Global Outcomes guidelines recommend annual screening for diabetic nephropathy using urine albumin to creatinine ratio (uACR) and estimated glomerular filtration rate (eGFR) to enable early detection of chronic kidney disease (CKD) and timely initiation of disease modifying therapy. Despite these recommendations, screening adherence remains suboptimal. Within our large primary care focused healthcare system, only 55% of patients with diabetes were appropriately screened for CKD, with approximately 70% of unscreened patients missing only uACR. This quality improvement initiative aimed to improve CKD screening rates through implementation of point of care (POC) uACR testing across primary care practices.

Methods

Clinitek Microalbumin POC uACR testing was sequentially implemented across 64 primary care practices from July 2025 to April 2026. Results were categorized as normal (30 mg/g), moderately elevated (30–300 mg/g), or severely elevated (>300 mg/g). Monthly tracking included test volumes and CKD screening rates among patients with diabetes (completion of both uACR and eGFR). Abnormal results prompted confirmatory quantitative testing per guideline recommendations.

Results

During the 9 month period, 8,287 POC uACR tests were completed. Among 8,278 valid results, 47.2% were normal, 45.1% showed moderate albuminuria, and 7.7% showed severe albuminuria, yielding an abnormal rate of 52.8%. Active practices increased from 38 to 64, and monthly volume rose from 594 to 1,275 tests. Network wide CKD screening rates improved from 55.7% to 61.8% (11% relative improvement). POC testing was associated with a 66.5% cost reduction compared with laboratory based quantitative uACR testing.

Conclusion

POC uACR testing improved CKD screening among patients with diabetes in primary care settings. Improved access and elimination of a separate laboratory visit likely contributed to increased screening completion. The high prevalence of abnormal findings supports the value of POC screening for earlier CKD detection and initiation of guideline directed therapy. Cost savings and rapid results support scalability across primary care networks.

Table 1