Abstract: TH-PO0577
Cost-Effectiveness of Population-Based Albuminuria Screening for Cardiovascular and Kidney Disease Prevention Among US Adults
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
- Zhang, Donglan S., CKD Prognosis Consortium, New York, New York, United States
- Gansevoort, Ron T., CKD Prognosis Consortium, New York, New York, United States
Group or Team Name
- CKD Prognosis Consortium
Background
Albuminuria is an underrecognized marker of kidney and vascular injury associated with cardiovascular disease (CVD), chronic kidney disease (CKD) progression, and kidney failure. Although urine albumin-to-creatinine ratio (uACR) testing is recommended in high-risk groups, testing remains low. We evaluated the cost-effectiveness of population-based albuminuria screening for preventing cardiovascular and kidney outcomes in US adults.
Methods
We used a modified US CVD Policy Model, an individual-level microsimulation model linked to a CKD/kidney failure risk component. The cohort represented US adults with demographics, cardiovascular risk factors, eGFR, and albuminuria estimated from NHANES 2010–2020 and US-based cohort studies and was followed over a lifetime horizon. We compared usual care with one-time population-based uACR screening at age 40-79 years. Adults were assumed to provide a urine sample during an annual physical exam in primary care. Following screening positivity, ACE inhibitor/ARB and SGLT2 inhibitor therapy were initiated among eligible individuals not already receiving them. Treatment was modeled for uACR ≥30 mg/g in individuals with diabetes and uACR ≥200 mg/g in those without diabetes, consistent with KDIGO guidance. Costs, quality-adjusted life-years (QALYs), incremental cost-effectiveness ratios (ICERs), and cardiovascular and kidney failure events averted were assessed from the US health care sector perspective with costs and QALYs discounted 3% annually.
Results
In a simulation of 250,000 adults, compared to usual care, a one-time screening between ages 40-79 years averted >10,000 cardiovascular and kidney failure events in the treated population. At the American Heart Association recommended $120,000/QALY willingness-to-pay threshold, albuminuria screening and treatment was highly cost-effective (ICER <$50,000/QALY).
Conclusion
Population-based albuminuria screening followed by guideline-concordant cardiorenal-protective treatment may reduce cardiovascular and kidney failure events and be cost-effective compared with usual care in the US. ICER estimates are influenced by screening frequency and age, and treatment costs.
Funding
- NIDDK Support