Screening for risk with albuminuria: should we start from here?

Of course, albuminuria was the characteristic finding in Bright’s disease and was the cause of the ‘coagulable urine’. The prognostic importance of albuminuria was first recognized in diabetic nephropathy in which changes in albuminuria usually precede the decline in renal function. However, albuminuria provides prognostic information in all causes of progressive chronic kidney disease (CKD) and in fact provides a similar amount of information as estimates of kidney function (eGFR) itself [1]. Recent studies have shown that the presence of substantial (or ‘macro-’) albuminuria increases the risk of poor renal outcomes by an order of magnitude [2]. Mechanistically, in renal disease, macroalbuminuria is a marker of glomerular damage and may also be a mediator of subsequent tubular injury [3].