Evidence mapPaperPMID 41345917Full record

SynthesisBMC nephrology2025

Underutilization of albuminuria screening in adults with diabetes mellitus or hypertension: a systematic review and meta-analysis.

Mohamed A Albekery, Ibrahim S Alhomoud, Lama S Alabdulathim, Marwah A Almajed, Amjad A Alobaid, Manar K Alomair, Sukainah A Al Shehab, Khalid A Alhasan, Abdullah Al Hamid

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in BMC nephrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Current and Emerging Pharmacological Therapies for Hypertriglyceridemia.International journal of molecular sciences · 2026
    Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Mohamed A AlbekeryDepartment of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, 31982, Saudi Arabia.
Ibrahim S AlhomoudDepartment of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim, 51452, Saudi Arabia. i.alhomoud@qu.edu.sa.
Lama S AlabdulathimDepartment of Pharmacy, Almoosa Rehabilitation Hospital, Al-Ahsa, 36322, Saudi Arabia.
Marwah A AlmajedDepartment of Pharmacy, Obeid Specialized Hospital, Al-Ahsa, 31982, Saudi Arabia.
Amjad A AlobaidDepartment of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, 31982, Saudi Arabia.
Manar K AlomairDepartment of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, 31982, Saudi Arabia.
Sukainah A Al ShehabSchool of Medicine, University College Dublin, Dublin, Ireland.
Khalid A AlhasanDepartment of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Abdullah Al HamidDepartment of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, 31982, Saudi Arabia.

Funding

King Faisal University KFU252866
6 · The paper itself

Abstract

backgroundGuidelines recommend routine urine albumin-to-creatinine ratio (uACR) screening in patients with diabetes (annual) and hypertension (at least once, with follow-up annually if CKD is found). However, real-world adherence remains uncertain and appears suboptimal. This study aimed to quantify the global prevalence of albuminuria testing in high-risk adults with hypertension and/or diabetes.

methodsWe conducted a systematic review and meta-analysis of observational studies reporting the proportion of adults with diabetes mellitus, hypertension, or both who underwent albuminuria testing in routine care. Multiple databases were searched through Web of Science, PubMed, Google Scholar, and Scopus. Pooled uACR testing prevalence was calculated using random-effects meta-analysis of proportions, with heterogeneity assessed by Cochran's Q and I² statistics. Subgroup analyses examined differences by patient group, test modality, and country income level.

resultsThirty studies (from diverse countries and settings) met the inclusion criteria, involving over 29 million patients. Albuminuria testing rates were low in most settings. Overall, only about one in five high-risk patients underwent a uACR test in routine clinical practice. Pooled uACR testing prevalence was approximately 22% (fixed-effect model dominated by a large U.S. dataset), and 49% (95% CI: 7-93%) in a random-effects model accounting for extreme between-study variability (I² ~100%). Testing uptake ranged from < 5% in some systems to nearly 100% in protocolized programs. Subgroup comparisons showed higher rates in diabetes-focused and screening-driven studies, whereas hypertension cohorts had particularly low uptake.

conclusionsuACR testing remains underutilized among patients with hypertension or diabetes. This gap between guidelines and practice leads to delayed CKD detection and timely initiation of appropriate treatment. CLINICAL TRIAL NUMBER: Not applicable.

Indexed as

AlbuminuriaDiabetes MellitusHypertensionMass ScreeningHumansPrevalenceAlbuminuria testingChronic kidney diseaseDiabetes mellitusGuideline implementationHypertensionScreening practices

Identifiers

PMID41345917
PMCPMC12781434

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.