A simple screening test for urine protein could be used to identify individuals at highest risk of rapid kidney function decline,according to a new research.
Using this test could lead to potentially earlier and more effective treatments,lowering patients risks of developing kidney failure and dying prematurely,scientists said.
These patients would also benefit the most from serial kidney function monitoring and early treatments to prevent kidney failure.
William Clark,MD,University of Western Ontario and London Health Sciences Centre,in London,Canada,and his colleagues followed 2,574 participants in a community-based clinic for an average of seven years.
They found that a positive dipstick urine test was a strong predictor of rapid kidney function decline. Overall,2.5 percent of participants in the study had a urinary protein concentration at the start of the study.
The test correctly identified whether or not individuals had rapid kidney function decline in 90.8 percent of participants,mislabeled 1.5 percent as having the condition,and missed 7.7 percebt who were later identified as having the condition.
Among those with certain risk factors (cardiovascular disease,age >60 years,diabetes,or hypertension),the probability of identifying rapid kidney function decline from serial kidney function measurements increased from 13 percent to 44 percent after incorporating a positive dipstick test.
We showed that routine inexpensive urine dipstick screening in a population with and without risk factors will allow primary clinicians to follow fewer patients with serial monitoring to identify those with rapid kidney function decline that will potentially benefit from earlier referral and therapeutic intervention, said Dr. Clark.
The study will be published in the Journal of the American Society Nephrology.