Q&A

Annual proteinuria screening not cost-effective

J Fam Pract. 2004 April;53(4):261-268
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  • CLINICAL QUESTION: Is annual proteinuria screening in adults cost-effective?
  • STUDY DESIGN: Cost-effectiveness analysis
  • SETTING: Not applicable
  • SYNOPSIS: The majority of patients who develop ESRD go undetected until prevention is ineffective. The presence of low levels of urine protein can be an early marker of increased risk of progressive kidney disease, but it is unclear whether the screening of all adults for proteinuria is indicated. Screening diabetic patients for proteinuria with an annual dipstick has already been shown to be cost-effective.
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BOTTOM LINE

Annual screening of adults to detect proteinuria and prevent end-stage renal disease (ESRD) is not cost-effective unless directed only at high-risk groups (that is, those patients with diabetes and hypertension). Screening every 10 years beginning at the age 60 years, however, is highly cost-effective. (LOE=1b)

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