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| Name | Class |
|---|---|
| University Medical Center Groningen | OTHER |
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Early detection of kidney disease
Early detection and appropriate treatment of kidney disease is important as this may prevent future cardiovascular complications and end-organ damage more effectively than intervention in more advanced stages of disease. There is a well-established relationship between albuminuria and renal- and cardiovascular disease. Elevated albuminuria has a relatively high prevalence in the general population (5-9%). The prevalence of albuminuria is even higher in high-risk patients with diabetes Mellitus, hypertension, obesity, cardiovascular disease and lipid disorders. Adequate treatment of albuminuria, preferable at early stages can prevent both cardiovascular and renal disease progression. However, scarce epidemiological data show that albuminuria measurements are only conducted in a minority of individuals and disease recognition is suboptimal, even in high-risk groups. The current study aims to evaluate if and how early identification of chronic kidney disease by targeted screening of albuminuria levels is feasible in primary care (pharmacies and general practitioners) to optimally discover and treat patients with elevated albuminuria.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Screening | Only one group will be evaluated during the SALINE study. Everyone that meets the inclusion criteria of having a high risk for albuminuria is invited to participate. During participation, subjects are asked to collect one or more urine samples for albuminuria determination. If albuminuria is high (>= 3,0 mg/mmol) subjects are invited for a visit. During the visit non-invasive measurements (BMI, PoC HbA1c, eGFR, blood pressure and heart rate) are taken to determine the cardiovascular risk. Furthermore, medication use is reviewed. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Albuminuria test | Diagnostic Test | During participation, subjects are asked to collect one or more urine samples for albuminuria determination. |
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| Measure | Description | Time Frame |
|---|---|---|
| The prevalence of elevated albuminuria | defined as a confirmed urinary albumin creatinine ratio (UACR) ≥ 3.0 mg/mmol. | 1-2 weeks after invitation |
| Measure | Description | Time Frame |
|---|---|---|
| The prevalence of unknown elevated albuminuria | defined as elevated albuminuria not reported by the subject or previously recorded in electronic medical records of the subjects' general practice or pharmacy. | through study completion, an average of 5 weeks |
| Average costs per subject |
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Inclusion Criteria:
Exclusion Criteria:
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Subjects with a high risk of (developing) chronic kidney disease will be recruited in primary care practices and pharmacies from the General Practitioners Research Institute (GPRI) network. The organizational model of GPRI is based on the participation of independent practices and pharmacies in the Netherlands, well-trained GPs, pharmacists and their staff. Male and female subjects aged above 18 years that meet the inclusion criteria will be eligible for the study.
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| Name | Affiliation | Role |
|---|---|---|
| H.J. Lambers Heerpink, Prof. dr. | University Medical Center Groningen | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| General Practitioners Research Institute | Groningen | 9713GH | Netherlands |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40247889 | Derived | van Mil D, Kieneker LM, Harms E, Prins GH, van Geer-Postmus I, Mepschen M, Leving MT, Stoker N, Herman Kocks JW, Gansevoort RT, Lambers Heerspink HJ. Effectiveness of a systematic home-based albuminuria screening programme to detect chronic kidney disease in high-risk individuals in primary care (SALINE): a cross-sectional screening study. EClinicalMedicine. 2025 Apr 8;82:103185. doi: 10.1016/j.eclinm.2025.103185. eCollection 2025 Apr. |
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| ID | Term |
|---|---|
| D051436 | Renal Insufficiency, Chronic |
| D000419 | Albuminuria |
| ID | Term |
|---|---|
| D051437 | Renal Insufficiency |
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
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| HbA1c test | Diagnostic Test | During the screening visit, HbA1c will be measured with a point-of-care test (Affinion HbA1c, Abbott). |
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| Creatinine test | Diagnostic Test | During the screening visit, creatinine will be measured with a point-of-care test (i-STAT Alinity handheld analyser, Abbott). |
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by screening for albuminuria via pharmacies versus general practitioners. |
| through study completion, an average of 5 weeks |
| the proportion of invited subjects that was identified as having hidden kidney disease | by screening for albuminuria via pharmacies versus general practitioners. | through study completion, an average of 5 weeks |
| D005261 |
| Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
| D002908 | Chronic Disease |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D011507 | Proteinuria |
| D014555 | Urination Disorders |
| D020924 | Urological Manifestations |
| D012816 | Signs and Symptoms |