Frequency of albuminuria in primary care: a cross-sectional study.
BACKGROUND
We aimed to assess the point prevalence of microalbuminuria (MAU) in a sample of unselected consecutive primary-care attendees, with particular focus on patients with diabetes mellitus (with and without additional concomitant diseases) and those with hypertension.


METHODS
Cross-sectional observational study in a nationwide representative sample of 1912 primary-care practices and a patient population consisting of 39 125 primary-care attendees. Diagnoses for diabetes, hypertension and co-morbidities were provided by the treating physician and complemented by blood pressure (BP) measurements and selected lab tests. Screening for microalbuminuria (>20 and <200 microg/ml) was done with a spot urine dipstick test.


RESULTS
The clinical diagnosis of nephropathy was assigned to 7.6% of patients. The point prevalence of MAU was 19.0% in the total sample; the proportion was 33.6% in diabetics whereas the diagnosis was assigned to only 7.1% in the total sample. Amongst diabetic patients with MAU, 92.6% had BP above the target value of <130/80 mmHg. Frequency rates rose with increasing BP (e.g. 20.6% in diabetic patients with BP<120/70 mmHg, and 36.3% in diabetic patients with BP>140/90 mmHg). Of note, patients with MAU had a higher burden of co-morbidity compared to those without MAU.


CONCLUSIONS
We found a high prevalence of MAU in primary care, particularly in diabetic patients. The frequency of MAU was closely related to the BP level and the degree of co-morbidity. The present study underlines the magnitude of the problem of MAU in primary care, and should serve as a starting point to initiate measures to address this important public health issue.
Bramlage
Peter
P
Institute for Clinical Pharmacology, Medical Faculty, Technical University of Dresden, Dresden, Germany. peter.bramlage@mailbox.tu-dresden.de
Pittrow
David
D
Lehnert
Hendrik
H
Höfler
Michael
M
Kirch
Wilhelm
W
Ritz
Eberhard
E
Wittchen
Hans-Ulrich
HU
D000293:Adolescent; D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000175:diagnosis / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology; D008403:Mass Screening; D008875:Middle Aged; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012307:Risk Factors