Abstract: TH-PO989
Utility of a Novel Point-of-Care Test for Albuminuria in Communities at High Risk for CKD
Session Information
- CKD Epidemiology, Risk Factors, Prevention - I
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Tungsanga, Somkanya, Chulalongkorn University, Bangkok, Bangkok, Thailand
- Kulvichit, Win, Chulalongkorn University, Bangkok, Bangkok, Thailand
- Peerapornratana, Sadudee, Chulalongkorn University, Bangkok, Bangkok, Thailand
- Praditpornsilpa, Kearkiat, Chulalongkorn University, Bangkok, Bangkok, Thailand
- Bello, Aminu K., University of Alberta, Edmonton, Alberta, Canada
- Srisawat, Nattachai, Chulalongkorn University, Bangkok, Bangkok, Thailand
Background
Albuminuria is a key prognostic marker in chronic kidney disease (CKD). Reliable testing tools for albuminuria and are scarce in many world settings due to limited availability and cost. We tested the utility of novel and low-cost point-of-care test (POCT) for albuminuria to asymptomatic individuals at high risk of CKD in Thailand.
Methods
A community-based cohort study of 2,307 adults with hypertension, diabetes, and/or over age 60 in Ban Phaeo District, Samut Sakhon Province, Thailand. We measured serum creatinine and urine albumin-creatinine ratio (UACR) using a POCT urine albumin strip test (Albii®, K. BioSciences, Bangkok, Thailand) and urine dipstick test for protein, and validated with standard laboratory measures. To confirm the chronicity of abnormalities, participants with albuminuria, regardless of eGFR or patients with eGFR <60 ml/min/1.73m2 at the first screening (suspected CKD) received follow-up tests for CKD risk. CKD was defined based on standard criteria.
Results
At baseline, 468 participants had reduced eGFR and/or albuminuria. Follow ups were conducted with 260 participants 3 months later, and 140 were confirmed with CKD (Figure 1). Among those diagnosed with CKD, 68 had albuminuria (UACR ≥30mg/g) with normal eGFR, 49 had impaired eGFR without albuminuria, and 22 had both albuminuria and impaired eGFR (Figure 2). The median eGFR was 93.23 [87.82, 98.73] ml/min/m2, and the median UACR was 9.15 [5.09, 20.96] mg/g for all participants. The POCT urine albumin strip showed a sensitivity of 0.86, specificity of 0.98, and accuracy of 0.96 compared to the standard UACR. Conversely, the POCT urine dipstick for protein had poor sensitivity, positive predictive value, and accuracy. The test results and interpretation were mailed to each participant in a sealed envelope. Participants identified with CKD were advised to attend the outpatient kidney clinic at the district hospital for appropriate management to slow CKD progression.
Conclusion
The urine albumin strip test is a highly effective tool for conducting point-of-care screening for early CKD among high-risk populations. Given the test’s low cost- and ease of use, it can facilitate the implementation of large-scale and affordable early detection programs for CKD.
Funding
- Government Support – Non-U.S.