#2410 Albuminuria as a marker of kidney damage in individuals with previously undiagnosed chronic kidney disease based on data of AURA registry

Abstract Background and Aims Albuminuria (AU) is a marker of kidney damage and is included in the diagnostic criteria for chronic kidney disease (CKD) according to KDIGO guidelines. However in real-world clinical practice the use of this indicator is less widespread compared to the calculation of the glomerular filtration rate (GFR). To determine the phenotype of patients with previously undiagnosed CKD who are more likely to have diagnostically significant AU. Method AURA (NCT05690009) is a real-world clinical practice registry encompassing 34 regions of the Russian Federation. It included 4,531 patients aged >40 years without previously confirmed chronic kidney disease (CKD) or type 1 or type 2 diabetes mellitus. The level of albuminuria (AU) was determined once using test strips during patient enrollment into the registry. A threshold value of AU was set at 20 mg/L. For comparative analysis, all included patients were divided into two groups based on their test results. Results AU < 20 mg/L was observed in 1,592 patients (35.1%), while AU ≥20 mg/L was identified in 2,939 patients (64.9%). AU was more frequently detected among smokers (19.1% vs. 15.7%, P = 0.006), males (44.2% vs. 38.6%, P < 0.001), and older individuals (mean age 61 vs. 59 years, P < 0.001). Among registered chronic conditions, patients with “AU+” more commonly had cardiovascular diseases, prediabetes, metabolic syndrome, and chronic obstructive pulmonary disease (COPD) (Fig. 1). It should be noted that the detection of albuminuria (AU) did not influence the severity of arterial hypertension (AH), but it was more prevalent among patients with functional class 3–4 chronic heart failure (CHF) (29.8% vs. 52.1%, P = 0.049) compared to functional class 1–2 (70.2% vs. 74.9%, P = 0.049), as well as among those with a left ventricular ejection fraction (LVEF) <50% (15.2% vs. 10%, P = 0.007) compared to >50% (84.8% vs. 90%, P = 0.007). Conclusion Among patients with cardiovascular diseases, metabolic syndrome, and chronic obstructive pulmonary disease (COPD), diagnostically significant albuminuria was significantly more frequent. Thus, patients in these groups represent a high-risk population for chronic kidney disease (CKD), requiring early diagnosis, including the use of test strips, dynamic monitoring for confirming the diagnosis, as well as timely nephroprotective measures.