Validation of an Albuminuria Self-assessment Tool in the Multi-Ethnic Study of Atherosclerosis (MESA)

Abstract

<p class="Pa7"><strong>Objective: </strong>We previously developed an 8-item self-assessment tool to identify individuals with a high probability of having albuminuria. This tool was developed and externally validated among non-Hispanic Whites and non-Hispanic Blacks. We sought to validate it in a multi-ethnic cohort that also included Hispanics and Chinese Americans.</p><p class="Pa7"><strong>Design: </strong>This is a cross-sectional study.</p><p class="Pa7"><strong>Setting: </strong>Data were collected using stan­dardized questionnaires and spot urine samples at a baseline examination in 2000- 2002. The 8 items in the self-assessment tool include age, race, gender, current ciga­rette smoking, history of diabetes, hyperten­sion, or stroke, and self-rated health.</p><p class="Pa7"><strong>Participants: </strong>Of 6,814 community-dwelling adults aged 45-84 years participating in the Multi-Ethnic Study of Atherosclerosis (MESA), 6,542 were included in the primary analysis.</p><p class="Default"><strong>Main Outcome Measures: </strong>Albuminuria was defined as urine albumin-to-creatinine ratio ≥30 mg/g at baseline.</p><p class="Pa7"><strong>Results: </strong>Among non-Hispanic Whites, non- Hispanic Blacks, Hispanics, and Chinese Americans, the prevalence of albuminuria was 6.0%, 11.3%, 11.6%, and 10.8%, respectively. The c-statistic for discriminating participants with and without albuminuria was .731 (95% CI: .692, .771), .728 (95% CI: .687, .761), .747 (95% CI: .709, .784), and .761 (95% CI: .699, .814) for non-His­panic Whites, non-Hispanic Blacks, Hispan­ics, and Chinese Americans, respectively. The self-assessment tool over-estimated the probability of albuminuria for non-Hispanic Whites and Blacks, but was well-calibrated for Hispanics and Chinese Americans.</p><p><strong>Conclusions: </strong>The albuminuria self-assess­ment tool maintained good test charac­teristics in this large multi-ethnic cohort, suggesting it may be helpful for increasing awareness of albuminuria in an ethnically diverse population. <em>Ethn Dis.</em>2015;25(4):427- 434; doi:10.18865/ed.25.4.427</p>