The DOI matches its Crossref record; 29 of the 29 references it cites were found in a registry or an index.
Albuminuria Testing in Hypertension and Diabetes: An Individual-Participant Data Meta-Analysis in a Global Consortium
Open accessAbstract
Albuminuria is an under-recognized component of chronic kidney disease definition, staging, and prognosis. Guidelines, particularly for hypertension, conflict on recommendations for urine albumin-to-creatinine ratio (ACR) measurement. Separately among 1 344 594 adults with diabetes and 2 334 461 nondiabetic adults with hypertension from the chronic kidney disease Prognosis Consortium, we assessed ACR testing, estimated the prevalence and incidence of ACR ≥30 mg/g and developed risk models for ACR ≥30 mg/g. The ACR screening rate (cohort range) was 35.1% (12.3%–74.5%) in diabetes and 4.1% (1.3%–20.7%) in hypertension. Screening was largely unrelated to the predicted risk of prevalent albuminuria. The median prevalence of ACR ≥30 mg/g across cohorts was 32.1% in diabetes and 21.8% in hypertension. Higher systolic blood pressure was associated with a higher prevalence of albuminuria (odds ratio [95% CI] per 20 mm Hg in diabetes, 1.50 [1.42–1.60]; in hypertension, 1.36 [1.28–1.45]). The ratio of undetected (due to lack of screening) to detected ACR ≥30 mg/g was estimated at 1.8 in diabetes and 19.5 in hypertension. Among those with ACR <30 mg/g, the median 5-year incidence of ACR ≥30 mg/g across cohorts was 23.9% in diabetes and 21.7% in hypertension. Incident albuminuria was associated with initiation of renin-angiotensin-aldosterone system inhibitors (incidence-rate ratio [95% CI], diabetes 3.09 [2.71–3.53]; hypertension 2.87 [2.29–3.59]). In conclusion, despite similar risk of albuminuria to those with diabetes, ACR screening in patients with hypertension was low. Our findings suggest that regular albuminuria screening should be emphasized to enable early detection of chronic kidney disease and initiation of treatment with cardiovascular and renal benefits.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Screening using two tests with either being positive interpreted as a positive (leading to subsequent quantitative testing) increases the sensitivity to 97% but reduces the specificity to 83% (500,501).”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [501]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Pooling results from a bivariate randomeffects model gave sensitivity and specificity estimates of 76% (95% CI, 63-86%) and 93% (CI, 84-97%), respectively, for the semiquantitative test (501).”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [501]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“The authors concluded that a negative semiquantitative POC test result does not rule out albuminuria, whereas quantitative POC testing meets required performance standards and can be used to rule out albuminuria.”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [501]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Sensitivity and specificity estimates for the quantitative test were 96% (95% CI, 78-99%) and 98% (95% CI, 93-99%), respectively.”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [501]
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
International Diabetes Federation 2017
Carracher, A. M., Marathe, P. H., & Close, K. L. (2018) · Journal of Diabetes · doi:10.1111/1753-0407.12644 · Cited by 13,379
Ahmed, A., Jorna, T., & Bhandari, S. (2016) · The Nephron journals/Nephron journals · doi:10.1159/000447068 · Cited by 11,782
2018 ESC/ESH Guidelines for the management of arterial hypertension
Williams, B., Mancia, G., Spiering, W., Agabiti Rosei, E., Azizi, M., Burnier, M., Clement, D. L., Coca, A., de Simone, G., Dominiczak, A., et al. (2018) · European Heart Journal · doi:10.1093/eurheartj/ehy339 · Cited by 10,286
KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease
Stevens, P. E., Ahmed, S. B., Carrero, J. J., Foster, B., Francis, A., Hall, R. K., Herrington, W. G., Hill, G., Inker, L. A., Kazancıoğlu, R., et al. (2024) · Kidney International · doi:10.1016/j.kint.2023.10.018 · Cited by 8,530
Self-citationWhelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Dennison Himmelfarb, C., DePalma, S. M., Gidding, S., Jamerson, K. A., Jones, D. W., et al. (2018) · Hypertension · doi:10.1161/hyp.0000000000000065 · Cited by 7,391
Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy
Perkovic, V., Jardine, M. J., Neal, B., Bompoint, S., Heerspink, H. J. L., Charytan, D. M., Edwards, R., Agarwal, R., Bakris, G., Bull, S., et al. (2019) · New England Journal of Medicine · doi:10.1056/nejmoa1811744 · Cited by 6,189
Dapagliflozin in Patients with Chronic Kidney Disease
Heerspink, H. J. L., Stefánsson, B. V., Correa-Rotter, R., Chertow, G. M., Greene, T., Hou, F.-F., Mann, J. F. E., McMurray, J. J. V., Lindberg, M., Rossing, P., et al. (2020) · New England Journal of Medicine · doi:10.1056/nejmoa2024816 · Cited by 5,618
Cosentino, F., Grant, P. J., Aboyans, V., Bailey, C. J., Ceriello, A., Delgado, V., Federici, M., Filippatos, G., Grobbee, D. E., Hansen, T. B., et al. (2020) · European Heart Journal · doi:10.1093/eurheartj/ehz486 · Cited by 4,763
2020 International Society of Hypertension Global Hypertension Practice Guidelines
Unger, T., Borghi, C., Charchar, F., Khan, N. A., Poulter, N. R., Prabhakaran, D., Ramirez, A., Schlaich, M., Stergiou, G. S., Tomaszewski, M., et al. (2020) · Hypertension · doi:10.1161/hypertensionaha.120.15026 · Cited by 4,132
Cited by
Sorted by citations
KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease
Stevens, P. E., Ahmed, S. B., Carrero, J. J., Foster, B., Francis, A., Hall, R. K., Herrington, W. G., Hill, G., Inker, L. A., Kazancıoğlu, R., et al. (2024) · Kidney International · doi:10.1016/j.kint.2023.10.018 · Cited by 8,530
Self-citationMark, P. B., Stafford, L. K., Grams, M. E., Aalruz, H., ElHafeez, S. A., Abdelgalil, A. A., Abdulkader, R. S., Abeywickrama, H. M., Abiodun, O. O., Abramov, D., et al. (2025) · The Lancet · doi:10.1016/s0140-6736(25)01853-7 · Cited by 573
Self-citationWriting Group for the CKD Prognosis Consortium, Appel, L. J., Grams, M., Woodward, M., Harris, K., Arima, H., Chalmers, J., Yatsuya, H., Tamakoshi, K., Li, Y., et al. (2023) · JAMA · doi:10.1001/jama.2023.17002 · Cited by 396
Self-citationSacks, D. B., Arnold, M., Bakris, G. L., Bruns, D. E., Horvath, A. R., Lernmark, Å., Metzger, B. E., Nathan, D. M., & Kirkman, M. S. (2023) · Diabetes Care · doi:10.2337/dci23-0036 · Cited by 351
Albuminuria: An Underappreciated Risk Factor for Cardiovascular Disease
Barzilay, J. I., Farag, Y. M. K., & Durthaler, J. M. (2024) · Journal of the American Heart Association · doi:10.1161/jaha.123.030131 · Cited by 186
Metadata
- Authors
- Shin, J.-I., Chang, A. R., Grams, M. E., Coresh, J., Ballew, S. H., Surapaneni, A., Matsushita, K., Bilo, H. J. G., Carrero, J. J., Chodick, G., Daratha, K. B., Jassal, S. K., Nadkarni, G. N., Nelson, R. G., Nowak, C., Stempniewicz, N., Sumida, K., Traynor, J. P., Woodward, M., Sang, Y., Gansevoort, R. T., Chalmers, J., Tuttle, K., Alicic, R., McPherson, S., Jones, C., Singh, G., Green, J., Kirchner, H. L., Shalev, V., Bottinger, E. P., Loos, R. J. F., Ellis, S. B., Cuddeback, J., Ciemins, E., Carbonara, E., Dunning, S., Knowler, W. C., Looker, H. C., Kieneker, L. M., Bakker, S. J. L., Hillege, H. L., van der Harst, P., Jassal, S. K., Bergstrom, J., Ix, J., Kovesdy, C. P., Potukuchi, P., Trevisan, M., Elinder, C. G., Wettermark, B., Ärnlöv, J., Mark, P. B., Thomson, P. C., Geddes, C. C., Landman, G. W. D., van Hateren, K. J. J., Kleefstra, N., Gutierrez, O., Konta, T., Levey, A. S., Polkinghorne, K., Schäffner, E., Chen, J., & Surapeneni, A.
- Affiliations
- Johns Hopkins University (US)
- Geisinger Medical Center (US)
- University Medical Center Groningen (NL)
- Karolinska Institutet (SE)
- Tel Aviv University (IL)
- Providence St. Joseph Health on behalf of CURE-CKD Investigators, Spokane, WA (K.B.D.)
- Icahn School of Medicine at Mount Sinai (US)
- National Institutes of Health (US)
- American Medical Group Association (US)
- University of Tennessee Health Science Center (US)
- Queen Elizabeth University Hospital (GB)
- ORCID
- Shin, Jung-Im
- Chang, Alex R.
- Grams, Morgan E.
- Coresh, Josef
- Ballew, Shoshana H.
- Surapaneni, Aditya
- Matsushita, Kunihiro
- Bilo, Henk J.G.
- Carrero, Juan J.
- Chodick, Gabriel
- Daratha, Kenn B.
- Nadkarni, Girish N.
- Nelson, Robert G.
- Nowak, Christoph
- Stempniewicz, Nikita
- Sumida, Keiichi
- Traynor, Jamie P.
- Woodward, Mark
- Sang, Yingying
- Gansevoort, Ron T.
- Chalmers, John
- Tuttle, Katherine
- Alicic, Radica
- McPherson, Sterling
- Jones, Cami
- Singh, Gurmukteshwar
- Green, Jamie
- Kirchner, H. Lester
- Shalev, Varda
- Loos, Ruth J.F.
- Ellis, Stephen B.
- Ciemins, Elizabeth
- Dunning, Stephan
- Knowler, William C.
- Looker, Helen C.
- Bakker, Stephan J.L.
- Hillege, Hans L.
- Ix, Joachim
- Kovesdy, Csaba P.
- Potukuchi, Praveen
- Trevisan, Marco
- Wettermark, Björn
- Ärnlöv, Johan
- Mark, Patrick B.
- Thomson, Peter C.
- Geddes, Colin C.
- Landman, Gijs W.D.
- Kleefstra, Nanne
- Konta, Tsuneo
- Levey, Andrew S.
- Polkinghorne, Kevan
- Venue
- Hypertension
- Published
- 2021-10
- Volume
- 78
- Issue
- 4
- Pages
- 1042-1052
- ISSN
- 0194-911X (ISSN-L)
- 1524-4563
- PMC
- PMC8429211
- OpenAlex
- W3188495695
- Semantic Scholar
- 9fd2f82a888974bc1547c07692b4c2ec79ecb7a5
- Cited by
- 155
- References
- 29
- Citations by year
- 2026: 31 · 2025: 51 · 2024: 26 · 2023: 28 · 2022: 18 · 2021: 1
- FWCI
- 2.99
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- other-oa
- Locations
- Hypertension (publishedVersion, other-oa)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, other-oa)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- UNSWorks (University of New South Wales, Sydney, Australia) (submittedVersion, cc-by-nc-nd)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
- Funders
- National Heart, Lung, and Blood Institute (K24HL155861)
- National Institute of Diabetes and Digestive and Kidney Diseases (K01DK121825, R01DK100446, R01DK115534, P30DK079626)
- Topics
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Nephrology › Acute Kidney Injury Research
- Keywords
- albuminuria, albumin-creatinine ratio, chronic kidney disease, diabetes mellitus, prevalence, incidence, risk model, systolic blood pressure, renin-angiotensin-aldosterone system inhibitors, early detection
- MeSH terms
- Adult, Aged, Albuminuria, Creatinine, Diabetes Mellitus, Glomerular Filtration Rate, Humans, Hypertension, Middle Aged, Renal Insufficiency, Chronic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
