High Prevalence and Low Awareness of Albuminuria in the Community Setting in the KDSAP

Min Zhuo; Ming-Yan Jiang; Rui Song; Suraj Sarvode Mothi; Sirine Bellou; Laura C Polding; Jiahua Li; Andrew Cho; Li-Li Hsiao

doi:10.1016/j.ekir.2019.12.011

High Prevalence and Low Awareness of Albuminuria in the Community Setting in the KDSAP

Kidney Int Rep. 2019 Dec 27;5(4):475-484. doi: 10.1016/j.ekir.2019.12.011. eCollection 2020 Apr.

Authors

Min Zhuo^{1

2}, Ming-Yan Jiang^{2

3}, Rui Song², Suraj Sarvode Mothi², Sirine Bellou², Laura C Polding⁴, Jiahua Li², Andrew Cho², Li-Li Hsiao²

Affiliations

¹ Renal Division, Department of Internal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
² Renal Division, Department of Internal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
³ Renal Division, Department of Internal Medicine, Chi Mei Medical Center, Taiwan.
⁴ Stanford University School of Medicine, Stanford, California, USA.

Abstract

Introduction: Albuminuria is a sign of kidney disease and associated with adverse outcomes. However, most individuals with albuminuria are unaware of it. The Kidney Disease Screening and Awareness Program (KDSAP) aims for early detection and raising awareness of albuminuria, targeting underserved populations in communities. This study will assess the prevalence and awareness of albuminuria and identify associated risk factors among KDSAP participants.

Methods: KDSAP participants ≥18 years old without a history of dialysis or kidney transplant were included. Albuminuria was identified by dipstick urinalysis. Individuals with albuminuria who answered yes to either of the following 2 questions were defined as being aware: (i) Have you ever had protein in the urine? (ii) Do you have kidney disease?

Results: Among 2304 participants, 461 (20.0%) had albuminuria: 16.3% with trace or 1+ (low degree) and 3.7% with 2+ or more (high degree). Correlating factors of albuminuria included young age, male sex, African American descent, self-reported diabetes, hypertension, family history of kidney disease, and smoking. Overall albuminuria awareness was 15.8%, but awareness inversely correlated to younger age groups: 7.0% for ages 18-39 years, 13.5% for ages 40-59 years, and 24.0% for ages ≥60 years (P < 0.001). A high degree of albuminuria (vs. low, odds ratio: 5.04, P < 0.001) and concurrent hematuria (odds ratio: 2.12, P=0.024) were both associated with higher awareness; conversely, risk factors for low awareness included African American and better self-assessments of health.

Conclusions: There was a high albuminuria prevalence among KDSAP participants, yet low awareness. KDSAP can potentially be a useful model for detecting albuminuria and raising awareness in communities.

Keywords: Kidney Disease Screening and Awareness Program (KDSAP); albuminuria; awareness; chronic kidney disease (CKD); community screening; proteinuria.