(HealthDay News) — Few patients with abnormal protein dipstick results have follow-up albuminuria quantification, according to a research letter published online Oct. 1 in the Annals of Internal Medicine.
Noting that guidelines recommend follow-up albumin-creatinine ratio (ACR) testing if the protein dipstick test result is abnormal, Yunwen Xu, PhD, from the Johns Hopkins Bloomberg School of Public Health in Baltimore, and colleagues examined follow-up albuminuria quantification after an initial abnormal result on a protein dipstick test.
Overall, 13 percent of the 1,042,740 participants with urine dipstick testing in 33 US health systems had an abnormal protein dipstick test result. The researchers found that the cumulative one-year incidence of follow-up albuminuria testing was 6.7 and 4.0% among participants with abnormal dipstick test results at baseline and those with normal results at baseline, respectively. Slightly higher follow-up testing rates were seen with higher values of the initial abnormal test: 6.3, 7.3 and 8.0% for 1+, 2+, and 3+ or greater protein, respectively. Follow-up testing occurred more often in those with versus without diabetes (16.6 versus 3.8%). Among the 7,967 participants with initial abnormal results on a dipstick protein test with follow-up albuminuria quantification testing, 43.3% had a positive result confirming albuminuria. There was an increase in this percentage with higher baseline protein levels from 36.3 to 53.0 to 64.9% for 1+, 2+, and 3+ or greater protein.
“Improved education on the necessity of follow-up albuminuria quantification and the implementation of guideline-recommended ACR testing would benefit many patients through earlier detection and treatment of albuminuric chronic kidney disease,” the authors write.
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