Measuring albumin in urine allows early detection of chronic kidney disease

The renal function of people with an increased level of albumin in their urine deteriorates more quickly and they have a much higher risk of suffering renal failure. Measuring the level of albumin (a type of protein) is therefore a good and relatively simple way of identifying patients with chronic kidney disease. This is one of the findings of a PhD project carried out by Marije van der Velde from the University Medical Center Groningen. Her research was part of the large-scale PREVEND (Prevention of Renal and Vascular End-stage Disease) study of heart, renal and vascular disease. She will be awarded a PhD for her thesis by the University of Groningen on 12 June 2013.

Approximately 10 percent of the population in western countries has chronic kidney disease. Despite the serious health risks this entails, many of these people do not even know that they have a problem. Complications include cardiovascular disease, a need for dialysis or a kidney transplant and even premature death. The early detection and treatment of patients with chronic kidney disease can help to reduce these risks.

Van der Velde’s research showed that the disease can be detected in an early stage by testing urine. The renal function of people with raised levels of albumin in the urine (this is known as albuminuria) deteriorates more quickly than those of people with normal levels. Furthermore, the risk of renal failure can be up to 100 times greater.

Van der Velde also found that patients suffering from metabolic syndrome (people who are overweight and changes in their metabolism as a consequence of this), and who also had raised levels of albumin in their urine, had a higher risk of developing complications. ‘These include diabetes mellitus, cardiovascular disease or chronic kidney disease’, says Van der Velde.

As a result of her research findings, the definition and classification of chronic kidney disease have been amended. According to Van der Velde, measuring albumin in the urine of the population is a promising way of identifying patients with early-stage chronic kidney disease. If people are detected, they can also be treated. ‘Medication to lower the blood pressure causes a drop in amount of protein inurine’, continues the PhD student. The next step is to find out whether this treatment will work in the long term. If so, Van der Velde would recommend wide-scale screening for albumin in the urine as a means of detecting chronic kidney disease.

Marije van der Velde (Amersfoort, 1980) studied Medicine at the University of Groningen. She carried out her PhD research in the Nephrology Department of the University Medical Center Groningen as part of the long-term PREVEND study. Her thesis is entitled ‘Renal risk markers and patient prognosis in chronic kidney disease’. She is currently working as a junior doctor of internal medicine in the Deventer Hospital.