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. 2025 Apr 25;18(5):sfaf123.
doi: 10.1093/ckj/sfaf123. eCollection 2025 May.

Impact of albuminuria screening in primary care on the detection and management of chronic kidney disease: findings from the ONDAAS study

Didier Sánchez-Ospina  1 , Sebastián Mas-Fontao  2   3   4 , Maria Martin Palencia  1 , Badawi Hijazi Prieto  5 , Cristina Gómez Sánchez  6 , Silvia Paredes Carcedo  7 , Maria Rodríguez Albo  1 , Jesús Egido  2   3   8 , Alberto Ortiz  2   8 , Emilio Gonzalez-Parra  2   8 , Maria Jesus Izquierdo Ortiz  5 ; ONDAAS study investigators
Collaborators, Affiliations

Impact of albuminuria screening in primary care on the detection and management of chronic kidney disease: findings from the ONDAAS study

Didier Sánchez-Ospina et al. Clin Kidney J. .

Abstract

Background: The prevalence and burden of chronic kidney disease (CKD) is increasing. Despite available early detection methods, many individuals with CKD remain undiagnosed. We evaluate the effectiveness of albuminuria screening for early detection and management of CKD in the primary care setting.

Methods: We conducted a cross-sectional, multicenter epidemiological study in primary care centers in the province of Burgos, Spain, from February to May 2024. The urinary albumin:creatinine ratio (uACR) was assessed in 9890 adults attending primary care visits. The primary finding was the prevalence of CKD defined by KDIGO guidelines thresholds for albuminuria and estimated glomerular filtration rate (eGFR), stratified by age, gender and motive for consultation.

Results: In total, 22.29% of participants met CKD criteria, with 14.04% showing uACR levels above 30 mg/g (albuminuria categories A2-A3) and 12.81% displaying reduced eGFR levels (categories G3-G5). Albuminuria screening identified CKD in 1338 (14.1%) participants, including 903 (10.88%) individuals with eGFR >60 mL/min/1.73 m² and 434 (35.57%) participants with CKD upgraded to higher risk due to albuminuria. Among individuals with CKD, 2123 (22.29%) participants were eligible for therapies to slow disease progression, per current KDIGO guidelines.

Conclusion: The ONDAAS study reveals a high prevalence of CKD among individuals attending primary care facilities, emphasizing the importance of albuminuria screening for early detection and risk stratification of CKD. Our findings demonstrate how early screening can significantly shape therapeutic choices and ultimately enhance patient care outcomes.

Keywords: CKD; CKD-EPI equation; albuminuria; diabetic nephropathy; hypertension.

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Conflict of interest statement

The authors declare no relevant financial or non-financial competing interests.

Figures

Figure 1:
Figure 1:
Flowchart illustrating the selection of subjects and the analysis of blood tests, showing exclusions and final counts for eGFR and uACR measurements.
Figure 2:
Figure 2:
eGFR (left) and uACR (right) according to not age in a scatter plot.
Figure 3:
Figure 3:
The potential impact on therapy was assessed based on KDIGO recommendations. Stacked bar chart showing the percentage usage of various treatments in patient groups with and without T2D.
See this image and copyright information in PMC

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