Exp Clin Endocrinol Diabetes 1999; 107(4): 244-251
DOI: 10.1055/s-0029-1212107
Article

© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Screening of diabetic patients for microalbuminuria in primary care — The PROSIT-Project

W. Piehlmeier1 , R. Renner2 , W. Schramm1 , T. Kimmerling1 , S. Garbe3 , R. Proetzsch3 , J. Fahn4 , K. Piwernetz5 , R. Landgraf1
  • 1Dept. of Internal Medicine „Innenstadt”, University of Munich, Germany
  • 2City Hospital Munich-Bogenhausen, Munich, Germany
  • 3Roche Diagnostics GmbH, Mannheim, Germany
  • 4AOK Munich, Germany
  • 5DiabCare-Office Munich, Germany
Further Information

Publication History

Publication Date:
14 July 2009 (online)

Summary

The PROSIT (Proteinuria Screening and Intervention) Project started in 1993 in order to obtain data on the prevalence of micro- and macroalbuminuria in diabetic patients treated in primary care, to establish an easy screening programme for microalbuminuria, in which also diabetic patients can participate in self-responsibility, and to implement a specific intervention programme for incipient nephropathy. In 58 representative doctor's offices 647 diabetic patients were included, who performed at home self-tests for microalbuminuria on three days within one week using the early morning urine and a newly developed qualitative immunologic teststrip for microalbuminuria. After storage they returned the same urine samples to their doctors' offices for semiquantitative retesting with the immunologic test-strip Micral-Test® II. In case of positive results the proteinuria dipstick Combur-9-Test® was applied in order to exclude other causes of positive microalbuminuria (e.g. urinary tract infection). Data of 569 patients (6% Type 1, 88% Type 2 and 6% secondary diabetes) could be analysed. Both qualitative self-testing for microalbuminuria at home and semiquantitative retesting in doctors' offices were found to be feasible. Based on semiquantitative retesting the prevalences of microalbuminuria (macroalbuminuria) were 19.6% (0%) in Type I diabetes, 17.2% (10.8%) in Type 2 diabetes and 11.7% (7.8%) in secondary diabetes. Type 2 diabetic patients showed a clear correlation between albuminuria and diabetes duration, HbA10, serum creatinine, triglycerides as well as micro- and macrovascular complications. 227 patients with micro- or macroalbuminuria were included into the ongoing PROSIT intervention programme.