This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (6)  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in JAMA  Topic Collections  • Renal Diseases  • Renal Diseases, Other  • Diagnosis  • Alert me on articles by topic

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: Dr Boulware and colleagues¹ concluded that a strategy of annual dipstick screening for proteinuria with follow-up testing and treatment with an angiotensin-converting enzyme (ACE) inhibitor would not be cost-effective to slow progression of kidney disease or to decrease mortality. We believe that their results were strongly influenced by a number of factors, including the low yield of the screening test, the high costs for the screening by the primary care physician, and the possible added reduction of cardiovascular morbidity that is not taken into account.

Based on our data² we think that screening for microalbuminuria would be more rational than screening for proteinuria. Among a primary prevention population, urinary albumin excretion of 0.3 g/dL or higher per 24 hours has been reported to be predictive for later occurrence of cardiovascular disease.^2-3 Retrospective subgroup analyses of a recent large-scale randomized controlled trial found that treatment with ACE inhibitors . . . [Full Text of this Article]

Ron T. Gansevoort, PhD; Paul E. de Jong, PhD
Department of Medicine

Maarten J. Postma, PhD
Department of Pharmaco-Epidemiology
University Hospital Groningen
Groningen, the Netherlands

RELATED ARTICLES

Cost-effectiveness of Screening for Proteinuria
Ron T. Gansevoort, Paul E. de Jong, and Maarten J. Postma
JAMA. 2004;291(12):1442-1443.
EXTRACT | FULL TEXT  

Cost-effectiveness of Screening for Proteinuria—Reply
L. Ebony Boulware, Bernard G. Jaar, and Neil R. Powe
JAMA. 2004;291(12):1443.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Pharmacoeconomics in nephrology: considerations on cost-effectiveness of screening for albuminuria
Postma et al.
Nephrol Dial Transplant 2008;23:1103-1106.
FULL TEXT  

Screening, Monitoring, and Treatment of Albuminuria: Public Health Perspectives
de Jong and Curhan
J. Am. Soc. Nephrol. 2006;17:2120-2126.
ABSTRACT | FULL TEXT