Association between albuminuria and proteinuria in the general population: The AsuDiab study

Robert C. Atkins, Esther M. Briganti, Paul Zimmet, Steven J. Chadban

Research output: Contribution to journalArticle

61 Citations (Scopus)

Abstract

Background. The relationship between urinary albumin and total protein excretion and the appropriateness of one test over the other are unclear due to the paucity of large epidemiological studies of albuminuria and proteinuria. In screening for renal and cardiovascular disease, whether to measure albuminuria, proteinuria or both, is currently an unanswered question. Methods. Random urine samples from 10 596 (94.2%) participants of the Australian Diabetes, Obesity and Lifestyle Study were tested for albuminuria (urine albumin:creatinine ≥30mg/g) and proteinuria (urine protein:creatinine ≥0.20mg/mg). This study was a representative sample of the national non-institutionalized population drawn from 42 randomly selected urban and non-urban areas (census collector districts) across Australia. Results. Among a representative cross-section of the Australian adult population, urine albumin excretion was strongly correlated with total protein excretion, particularly among the elderly, and those with diabetes mellitus, hypertension, obesity and renal impairment (P < 0.001). Albuminuria performed well as a screening test for proteinuria: sensitivity 91.7% [95% confidence interval (CI) 87.7-94.5%], specificity 95.3% (95% CI 94.9-95.7%) and negative predictive value 99.8% (95% CI 99.7-99.9%). However, among those with proteinuria, 8% excreted albumin within the normal range. Conclusions. While albuminuria may be a suitable test for general population screening for renal and cardiovascular disease, it should not replace testing for proteinuria in those with known or suspected renal disease.

LanguageEnglish
Pages2170-2174
Number of pages5
JournalNephrology Dialysis Transplantation
Volume18
Issue number10
DOIs
Publication statusPublished - 1 Oct 2003

Keywords

  • Albuminuria
  • Proteinuria
  • Renal disease
  • Screening

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

Cite this

Atkins, Robert C. ; Briganti, Esther M. ; Zimmet, Paul ; Chadban, Steven J. / Association between albuminuria and proteinuria in the general population : The AsuDiab study. In: Nephrology Dialysis Transplantation. 2003 ; Vol. 18, No. 10. pp. 2170-2174.
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Association between albuminuria and proteinuria in the general population : The AsuDiab study. / Atkins, Robert C.; Briganti, Esther M.; Zimmet, Paul; Chadban, Steven J.

In: Nephrology Dialysis Transplantation, Vol. 18, No. 10, 01.10.2003, p. 2170-2174.

Research output: Contribution to journalArticle

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T1 - Association between albuminuria and proteinuria in the general population

T2 - Nephrology Dialysis Transplantation

AU - Atkins, Robert C.

AU - Briganti, Esther M.

AU - Zimmet, Paul

AU - Chadban, Steven J.

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N2 - Background. The relationship between urinary albumin and total protein excretion and the appropriateness of one test over the other are unclear due to the paucity of large epidemiological studies of albuminuria and proteinuria. In screening for renal and cardiovascular disease, whether to measure albuminuria, proteinuria or both, is currently an unanswered question. Methods. Random urine samples from 10 596 (94.2%) participants of the Australian Diabetes, Obesity and Lifestyle Study were tested for albuminuria (urine albumin:creatinine ≥30mg/g) and proteinuria (urine protein:creatinine ≥0.20mg/mg). This study was a representative sample of the national non-institutionalized population drawn from 42 randomly selected urban and non-urban areas (census collector districts) across Australia. Results. Among a representative cross-section of the Australian adult population, urine albumin excretion was strongly correlated with total protein excretion, particularly among the elderly, and those with diabetes mellitus, hypertension, obesity and renal impairment (P < 0.001). Albuminuria performed well as a screening test for proteinuria: sensitivity 91.7% [95% confidence interval (CI) 87.7-94.5%], specificity 95.3% (95% CI 94.9-95.7%) and negative predictive value 99.8% (95% CI 99.7-99.9%). However, among those with proteinuria, 8% excreted albumin within the normal range. Conclusions. While albuminuria may be a suitable test for general population screening for renal and cardiovascular disease, it should not replace testing for proteinuria in those with known or suspected renal disease.

AB - Background. The relationship between urinary albumin and total protein excretion and the appropriateness of one test over the other are unclear due to the paucity of large epidemiological studies of albuminuria and proteinuria. In screening for renal and cardiovascular disease, whether to measure albuminuria, proteinuria or both, is currently an unanswered question. Methods. Random urine samples from 10 596 (94.2%) participants of the Australian Diabetes, Obesity and Lifestyle Study were tested for albuminuria (urine albumin:creatinine ≥30mg/g) and proteinuria (urine protein:creatinine ≥0.20mg/mg). This study was a representative sample of the national non-institutionalized population drawn from 42 randomly selected urban and non-urban areas (census collector districts) across Australia. Results. Among a representative cross-section of the Australian adult population, urine albumin excretion was strongly correlated with total protein excretion, particularly among the elderly, and those with diabetes mellitus, hypertension, obesity and renal impairment (P < 0.001). Albuminuria performed well as a screening test for proteinuria: sensitivity 91.7% [95% confidence interval (CI) 87.7-94.5%], specificity 95.3% (95% CI 94.9-95.7%) and negative predictive value 99.8% (95% CI 99.7-99.9%). However, among those with proteinuria, 8% excreted albumin within the normal range. Conclusions. While albuminuria may be a suitable test for general population screening for renal and cardiovascular disease, it should not replace testing for proteinuria in those with known or suspected renal disease.

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