Albuminuria Screening in People With Type 2 Diabetes in a Managed Care Organization
Farrah Keong, MPH,
Jennifer Gander, PhD,
Daniel Wilson, MD,
Jeffrey Durthaler, DPh,
Belkis Pimentel, MD,
Joshua I. Barzilay, MD
Affiliations
Farrah Keong, MPH
Business Intelligence Group, Kaiser Permanente of Georgia, Atlanta, Georgia
Jennifer Gander, PhD
Center for Research and Evaluation, Kaiser Permanente of Georgia, Atlanta, Georgia
Daniel Wilson, MD
Division of Cardiorenal Medicine, U.S. Medical Affairs, Bayer Pharmaceuticals, LLC, Whippany, New Jersey
Jeffrey Durthaler, DPh
Division of Cardiorenal Medicine, U.S. Medical Affairs, Bayer Pharmaceuticals, LLC, Whippany, New Jersey
Belkis Pimentel, MD
Department of Adult Medicine, Kaiser Permanente of Georgia, Atlanta, Georgia; Department of Population Care Management, Kaiser Permanente of Georgia, Atlanta, Georgia
Joshua I. Barzilay, MD
Division of Endocrinology, Kaiser Permanente of Georgia, Atlanta, Georgia; Division of Endocrinology Metabolism and Lipids, Department of Medicine, Emory School of Medicine, Atlanta, Georgia; Address correspondence to: Joshua Barzilay, MD, Division of Endocrinology, Kaiser Permanente of Georgia, 3650 Steve Reynolds Boulevard, Duluth GA 30096.
Introduction: Albuminuria—an increased amount of urine albumin, in milligrams, adjusted for grams of urine creatinine—is an early marker of diabetic kidney disease. Several new classes of medications are now available that effectively lower albuminuria levels with the potential to delay or prevent the progression of diabetic kidney disease. However, screening for albuminuria in the U.S. is low in population-based studies (64 years were more likely to have completed albuminuria screening. Screened individuals had lower HbA1c, blood pressure, and low-density lipoprotein cholesterol levels than those who were not screened. Conclusions: In an integrated healthcare model, it is possible to achieve consistently high rates of albuminuria screening in people with Type 2 diabetes, especially in groups at high risk for kidney disease.
