Diabetes is on the rise, and with it devastating complications in the form of chronie kidney disease (CKD) and cardiovascular disease (CVD). This is why international organizations are urging national health bodies to begin screening for microalbuminuria, as the International Society of Nephrology (ISN) has done in its formal Call to Act.

Microalbuminuria, a condition in which low but abnormal amounts of albumin are present in the urine, is an early risk marker for both CKD and CVD. But because the condition is not accompanied by any noticeable symptoms, its detection depends greatly on you who work in primary care.

Microalbuminuria is treatable, so screening for it can potentially benefit anyone. But the ISN Call to Act specifies three target groups, all of which have a strong relationship with primary care:

Patients with type 2 diabetes are most often treated in general practice, as are people with hypertension. And those in the risk zone for diabetes and hypertension, especially if they are over 50, are likely to undergo annual checkups. At the very least, people in all the se groups seek out primary care for advice regarding general symptoms.

In light of this, screening for microalbuminuria in primary care is both natural and convenient. But most importantly, it has the potential to reach large numbers of people at risk.

In fact, the very nature of primary care creates an advantage when it comes to preventing CKD and CVD through microalbuminuria screening. Because patients tum repeatedly to your clinic or practice, you know better than anyone which of them ought to be tested. Besides having access to their medical histories, you can identify lifestyle factors such as obesit y or smoking that put them at greater risk.

When this knowledge is applied in the form of proactive screening, it enables early detection and treatment that can preserve your patients' quaIity of life. If patents are tested only after symptoms appear, major damage may have already occurred.

Though a diagnosis of microalbuminuria is never welcome, the fact that it comes from primary care has its advantages. The same relationship that lets you identify patients at risk helps them feel comforted, secure and ready to listen should they exhibit the early signs of CKD or CVD.

Patients have a natural trust in the judgment of their doctor, which means you are in the best position to bring about a change. By working with your patients and drawing on what you know about their history and lifestyle, you can develop the treatment plan with the greatest potential for success.

And once that plan is determined, your established relationship offers a natural continuity that helps ensure effective follow-up.