title: Validation of an Albuminuria Self-assessment Tool in the Multi-Ethnic Study of Atherosclerosis.
abstract: OBJECTIVE
  We previously developed an 8-item self-assessment tool to identify individuals with a high probability of having albuminuria. This tool was developed and externally validated among non-Hispanic Whites and non-Hispanic Blacks. We sought to validate it in a multi-ethnic cohort that also included Hispanics and Chinese Americans.
  
  
  METHODS
  This is a cross-sectional study.
  
  
  METHODS
  Data were collected using standardized questionnaires and spot urine samples at a baseline examination in 2000-2002. The 8 items in the self-assessment tool include age, race, gender, current cigarette smoking, history of diabetes, hypertension, or stroke, and self-rated health.
  
  
  METHODS
  Of 6,814 community-dwelling adults aged 45-84 years participating in the Multi-Ethnic Study of Atherosclerosis (MESA), 6,542 were included in the primary analysis.
  
  
  METHODS
  Albuminuria was defined as urine albumin-to-creatinine ratio ≥ 30 mg/g at baseline.
  
  
  RESULTS
  Among non-Hispanic Whites, non-Hispanic Blacks, Hispanics, and Chinese Americans, the prevalence of albuminuria was 6.0%, 11.3%, 11.6%, and 10.8%, respectively. The c-statistic for discriminating participants with and without albuminuria was .731 (95% CI: .692, .771), .728 (95% CI: .687, .761), .747 (95% CI: .709, .784), and .761 (95% CI: .699, .814) for non-Hispanic Whites, non-Hispanic Blacks, Hispanics, and Chinese Americans, respectively. The self-assessment tool over-estimated the probability of albuminuria for non-Hispanic Whites and Blacks, but was well-calibrated for Hispanics and Chinese Americans.
  
  
  CONCLUSIONS
  The albuminuria self-assessment tool maintained good test characteristics in this large multi-ethnic cohort, suggesting it may be helpful for increasing awareness of albuminuria in an ethnically diverse population.
authors.affiliation: 1. Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Rikki M
authors.initials: RM
authors.lastname: Tanner
authors.affiliation: 2. The George Institute for Global Health, Nuffield Department of Population Health, University of Oxford, Oxford, UK ; 3. The George Institute for Global Health, University of Sydney, Sydney, Australia ; 4. Department of Epidemiology, Johns Hopkins University, Baltimore, MD.
authors.forename: Mark
authors.initials: M
authors.lastname: Woodward
authors.affiliation: 5. Department of Medicine, University of California San Francisco, San Francisco, CA.
authors.forename: Carmen
authors.initials: C
authors.lastname: Peralta
authors.affiliation: 6. Department of Medicine, University of Alabama at Birmingham, Birmingham, AL.
authors.forename: David G
authors.initials: DG
authors.lastname: Warnock
authors.affiliation: 6. Department of Medicine, University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Orlando
authors.initials: O
authors.lastname: Gutiérrez
authors.affiliation: 7. Department of Medicine, Columbia University Medical Center, New York, NY.
authors.forename: Daichi
authors.initials: D
authors.lastname: Shimbo
authors.affiliation: 9. Department of Medicine, Loyola University Medical Center, Chicago, IL.
authors.forename: Holly
authors.initials: H
authors.lastname: Kramer
authors.affiliation: 9. Kidney Research Institute, University of Washington, Seattle, WA.
authors.forename: Ronit
authors.initials: R
authors.lastname: Katz
authors.affiliation: 1. Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL ; 6. Department of Medicine, University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Paul
authors.initials: P
authors.lastname: Muntner
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000175:diagnosis* / Q000208:ethnology*; D050197:Atherosclerosis / Q000150:complications / Q000208:ethnology*; D003430:Cross-Sectional Studies; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D012647:Self-Assessment; D044465:White People
keywords: Albuminuria; Ethnicity; Kidney Disease; Race; Racial Disparities; Screening; Self-assessment