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Screening, Monitoring, and Treatment of Albuminuria: Public Health Perspectives

Paul E. de Jong^* and Gary C. Curhan

^* Division of Nephrology, Department of Medicine, University Medical Center Groningen, Groningen, The Netherlands; and Renal Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts

Address correspondence to: Dr. Paul E. de Jong, Division of Nephrology, Department of Medicine, University Medical Center Groningen, Groningen University, Hanzeplein 1, 9713 GZ Groningen, The Netherlands. Phone: 31-50-3612955; Fax: 31-50-3619310; E-mail p.e.de.jong{at}int.umcg.nl

Microalbuminuria is an early sign of progressive cardiovascular and renal disease in individuals with and without diabetes. Despite compelling data, at present only a minority of patients with diabetes and rarely individuals without diabetes are screened for albuminuria in a systematic way. All of the criteria to implement systematic albuminuria screening are fulfilled in diabetes, and most are nearly fulfilled for microalbuminuria screening in individuals without diabetes. Because of the growing evidence that treatment of microalbuminuria in individuals without diabetes may offer a cost-effective benefit to prevent cardiovascular disease, nephrologists and other health care providers should pay more attention to the early detection and subsequent treatment of individuals with microalbuminuria.

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