Towards a rational screening strategy for albuminuria: results from the unreferred renal insufficiency trial
| Autor: | Wim Van Biesen, Frans Vermeiren, Kathleen Eeckhaut, Francis Verbeke, Arjan van der Tol, Raymond Vanholder, Guy De Groote |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2010 |
| Předmět: |
Adult
Male medicine.medical_specialty Public Health and Epidemiology/Screening Public Health and Epidemiology/Environmental Health endocrine system diseases lcsh:Medicine urologic and male genital diseases Cohort Studies Impaired glucose tolerance Diabetes mellitus Internal medicine medicine Medicine and Health Sciences Albuminuria Humans Mass Screening Renal Insufficiency Risk factor lcsh:Science Mass screening Multidisciplinary HYPERTENSION business.industry MORTALITY lcsh:R Middle Aged medicine.disease female genital diseases and pregnancy complications Endocrinology Blood pressure Nephrology lcsh:Q Female Microalbuminuria medicine.symptom business Research Article Cohort study |
| Zdroj: | PLOS ONE PLoS ONE PLoS ONE, Vol 5, Iss 10, p e13328 (2010) |
| ISSN: | 1932-6203 |
| Popis: | Background There remains debate about the screening strategies for albuminuria. This study evaluated whether a screening strategy in an apparently healthy population based on basic clinical and biochemical parameters could be more effective than a strategy where screening for albuminuria is performed unselectively. Methodology/Principal Findings The Unreferred Renal Insufficiency (URI) Study is a cross-sectional study on the prevalence of metabolic risk factors in Belgian workers, volunteering to be screened during a routine yearly occupational check-up. Subjects (n = 295) with treated hypertension, known diabetes, treated dyslipidaemia, cardiovascular and renal disease were excluded. Among 1,191 apparently healthy subjects, 23% had unknown hypertension, 13% had impaired glucose tolerance, 15.4% had normoalbuminuria, 4.2% had microalbuminuria and 0.4% had macroalbuminuria. Subjects with resting heart rate ≥85 bpm, plasma glucose ≥5.6 mmol/L and blood pressure ≥140/90 mmHg were associated with albuminuria of any degree. A strategy where only subjects with at least one of these risk factors (n = 431) were screened for albuminuria, would identify all subjects with macroalbuminuria (5/5), 64% of those with microalbuminuria (32/50), and less than half of those with normoalbuminuria (81/183). An alternative strategy whereby subjects were first screened for presence of albuminuria, and additional cardiovascular risk factors were only measured in subjects positive for albuminuria (n = 238), would identify only 27% (118/431) of the subjects with additional and potentially modifiable cardiovascular risk factors. On the other hand, half of the subjects in this study with albuminuria (120/238, of which 102 had normoalbuminuria), had no additional cardiovascular risk factor at all. Conclusions Screening an apparently healthy population directly for albuminuria will result in a high percentage of false positives, mostly measured in the normal range. Screening for microalbuminuria and macroalbuminuria based on presence of additional, potentially modifiable risk factors appears to be more beneficial. Trial registration 2006 NCT00365911 |
| Databáze: | OpenAIRE |
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