#2919 Risk factors for albuminuria in patients with previously undiagnosed chronic kidney disease—AURA registry data

Abstract Background and Aims Albuminuria (AU) is a laboratory marker included in the diagnostic criteria for chronic kidney disease (CKD) according to KDIGO recommendations. However, in real-world clinical practice use of this marker is less widespread compared to the calculation of glomerular filtration rate (GFR). To identify risk factors for albuminuria in patients with previously undiagnosed CKD. Method AURA (NCT05690009) is a real-world clinical practice registry covering 34 regions of the Russian Federation. It included 4,531 patients older >40 years without previously verified CKD or type 1 or type 2 diabetes mellitus. The AU level was determined once using test strips at the time of patient enrollment in the registry. The threshold value for AU was set at 20 mg/L. To develop the model demographic data (age and sex) and information on chronic diseases from medical records were analyzed. Results AU <20 mg/L was identified in 1,592 patients (35.1%), while AU ≥20 mg/L was found in 2,939 patients (64.9%). A multivariate model revealed that the presence of AU ≥20 mg/L was significantly influenced by age, metabolic syndrome, prediabetes, cardiovascular pathology, chronic cystitis, and chronic obstructive pulmonary disease (COPD) (Fig. 1). ROC analysis of the multivariate risk prediction model for AU ≥20 mg/L in patients with previously undiagnosed CKD demonstrated satisfactory predictive value: area under the curve (AUC) of 61.5%, sensitivity of 66.0%, and specificity of 51.3%. Conclusion Data analysis from the AURA registry demonstrated that diagnostically significant AU in patients with previously undiagnosed CKD was significantly associated with age, cardiovascular diseases (myocardial infarction, atrial fibrillation), metabolic syndrome, prediabetes, chronic cystitis, and COPD. For older patients and those with these conditions, AU testing, including test strips, serves as an early CKD screening method, which can optimize medical care delivery and enable timely nephroprotective measures.