At-home self-test helps identify risk of kidney disease

Questions about age, diabetes, smoking and other health issues aim to identify people at risk for kidney disease.

Researchers at the University of Alabama at Birmingham have developed a self-assessment tool people can use at home as a good indicator of possible kidney disease long before obvious physical symptoms of the illness appear. Findings were reported in the August issue of the American Journal of Kidney Diseases, the journal of the National Kidney Foundation.

The tool is aimed at identifying people who are at risk of having excessive protein in their urine, or albuminuria, one of the markers of kidney disease that affects 10 million Americans. Albuminuria is also a risk factor for kidney failure, heart disease and death, but can go undetected until symptoms – including increased urination, swelling, fatigue or a skin rash –  occur, because a diagnosis requires a trip to the doctor for a urine test.

Study authors, led by Paul Muntner, Ph.D., professor in the Department of Epidemiology in the UAB School of Public Health, developed a questionnaire based on the most common risk factors for albuminuria: age; history of diabetes, hypertension or stroke; whether someone smokes; and other factors, such as race and sex.

Points are assigned for each question in the self-assessment, with a maximum of 25 points possible. Being older than 75 earns someone six points and having diabetes gets five points. Poor health, smoking and hypertension all earn three points each.

“Anyone who scores 10 or above — which is not that hard to do — has a high probability for having excessive protein in their urine and should talk to their doctor about getting screened with a urine test,” Muntner says. “Those tests are painless, and effective treatment is available for those who test positive.”

Having this tool available to the public is important because it’s something simple and easy for anyone to do at home, Muntner says. It provides them the information necessary to know if they need to be screened by a doctor, and could help people begin treatment with medication that can reduce their risks of developing kidney failure and other diseases.

“Albuminuria is emerging as an important risk factor for end-stage kidney disease, cardiovascular disease and all-cause mortality. However, early treatment may decrease the risk of these events,” he says. “Despite its importance in the disease process and the availability of effective treatments, awareness of albuminuria in the general population is low.”

Muntner and his colleagues used the database from Reasons for Geographic and Racial Differences in Stroke (REGARDS), a population-based investigation, funded by the National Institute of Neurological Disorders and Stroke of the National Institutes of Health and based at UAB, to develop the assessment. They used the National Health and Nutrition Examination Survey (NHANES) to validate the tool. Participants completed the study questionnaires and were examined by a health care professional.

Muntner’s co-authors on the paper are April P. Carson, Ph.D., Suzanne E. Judd, Ph.D., Emily B. Levitan, Ph.D., and David G. Warnock, M.D., of UAB; Mark Woodward, Ph.D., of the University of Sydney, Australia; Devin M. Mann, M.D., Boston University; and William McClellan, M.D., of Emory University.

This research project was supported by the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Department of Health and Human Services.

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