BACKGROUND: The prevalence of albuminuria in the general population is high, but awareness of it is low. Therefore, we sought to develop and validate a self-assessment tool that allows individuals to estimate their probability of having albuminuria. STUDY DESIGN: Cross-sectional study. SETTING & PARTICIPANTS: The population-based Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study for model development and the National Health and Nutrition Examination Survey (NHANES) 1999-2004 for model validation. US adults 45 years or older in the REGARDS Study (n = 19,697) and NHANES 1999-2004 (n = 7,168). PREDICTOR: Candidate items for the self-assessment tool were collected using a combination of interviewer- and self-administered questionnaires. OUTCOME: Albuminuria was defined as a urinary albumin to urinary creatinine ratio >/=30 mg/g in spot samples. RESULTS: 8 items were included in the self-assessment tool (age, race, sex, current smoking, self-rated health, and self-reported history of diabetes, hypertension, and stroke). These items provided a C statistic of 0.709 (95% CI, 0.699-0.720) and good model fit (Hosmer-Lemeshow chi(2)P = 0.49). In the external validation data set, the C statistic for discriminating individuals with and without albuminuria using the self-assessment tool was 0.714. Using a threshold of >/=10% probability of albuminuria from the self-assessment tool, 36% of US adults 45 years or older in NHANES 1999-2004 would test positive and be recommended for screening. Sensitivity, specificity, and positive and negative predictive values for albuminuria associated with a probability >/=10% were 66%, 68%, 23%, and 93%, respectively. LIMITATIONS: Repeated urine samples were not available to assess the persistency of albuminuria. CONCLUSIONS: 8 self-report items provide good discrimination for the probability of having albuminuria. This tool may encourage individuals with a high probability to request albuminuria screening.
AD - Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL; Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL. AN - 21620547 BT - American Journal of Kidney Diseases ET - 2011/05/31 LA - eng M1 - 2 N1 - Muntner, PaulWoodward, MarkCarson, April PJudd, Suzanne ELevitan, Emily BMann, Devin MMcClellan, WilliamWarnock, David GUnited StatesAmerican journal of kidney diseases : the official journal of the National Kidney FoundationAm J Kidney Dis. 2011 Aug;58(2):196-205. Epub 2011 May 26. N2 -BACKGROUND: The prevalence of albuminuria in the general population is high, but awareness of it is low. Therefore, we sought to develop and validate a self-assessment tool that allows individuals to estimate their probability of having albuminuria. STUDY DESIGN: Cross-sectional study. SETTING & PARTICIPANTS: The population-based Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study for model development and the National Health and Nutrition Examination Survey (NHANES) 1999-2004 for model validation. US adults 45 years or older in the REGARDS Study (n = 19,697) and NHANES 1999-2004 (n = 7,168). PREDICTOR: Candidate items for the self-assessment tool were collected using a combination of interviewer- and self-administered questionnaires. OUTCOME: Albuminuria was defined as a urinary albumin to urinary creatinine ratio >/=30 mg/g in spot samples. RESULTS: 8 items were included in the self-assessment tool (age, race, sex, current smoking, self-rated health, and self-reported history of diabetes, hypertension, and stroke). These items provided a C statistic of 0.709 (95% CI, 0.699-0.720) and good model fit (Hosmer-Lemeshow chi(2)P = 0.49). In the external validation data set, the C statistic for discriminating individuals with and without albuminuria using the self-assessment tool was 0.714. Using a threshold of >/=10% probability of albuminuria from the self-assessment tool, 36% of US adults 45 years or older in NHANES 1999-2004 would test positive and be recommended for screening. Sensitivity, specificity, and positive and negative predictive values for albuminuria associated with a probability >/=10% were 66%, 68%, 23%, and 93%, respectively. LIMITATIONS: Repeated urine samples were not available to assess the persistency of albuminuria. CONCLUSIONS: 8 self-report items provide good discrimination for the probability of having albuminuria. This tool may encourage individuals with a high probability to request albuminuria screening.
PY - 2011 SN - 1523-6838 (Electronic)0272-6386 (Linking) SP - 196 EP - 205 T2 - American Journal of Kidney Diseases TI - Development and Validation of a Self-assessment Tool for Albuminuria: Results From the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study VL - 58 ER -