AUSTRALIAN experts are considering whether urine albumin tests should be used in preference to urine dipsticks to detect renal disease.

An Australian working group is expected to publish a position statement by the end of the year on the role of urine albumin and protein in screening and monitoring of chronic kidney disease.

Associate Professor Timothy Mathew, medical director of Kidney Health Australia, said the group would “possibly make a recommendation that we pursue urine albumin preferentially over the more old fashioned dipsticks”.

Urinary albumin-to-creatinine ratio (ACR) spot tests were superior to urine dipstick tests based on their accuracy and the ease by which GPs could order the tests, he said. 

Meanwhile, an Italian study of 917 patients with hypertension but without diabetes, found those with microalbuminuria at baseline were seven times more likely to develop chronic renal insufficiency and twice as likely to develop cardiovascular events compared to those without microalbuminuria. 

Professor Mathew said the findings strengthened the case for “opportunistic screening” in patients with high blood pressure.He said the trial strengthened the case for ACE inhibitors and ARBs to be used preferentially in hypertensive patients with microalbuminuria.

Clin J am Soc Nephrol 2010; 1-8.