Though a diagnosis of microalbuminuria is never a welcome one, the message is clearer and more effective if it comes from you in primary care. The same relationship that lets you identify patients at risk can help them feel comforted, secure and ready to listen if they exhibit the early warning signs of CKD or CVD. Likewise, your interaction with your patients means opportunities to infl uence their behavior and diet, as well as to initiate proactive treatment. Patients have a natural trust in the judgment of their physician, which puts you in the best possible position to bring about a change.

By working with your patients and drawing on your knowledge of 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 and regular contact offer a natural continuity that facilitates effective follow-up.¹ In the illustration below, the steps in managing microalbuminuria have been organized into a fl ow chart. While the chart extends from regular screening to the referral of the patient to a renal team, effective management in primary care can help keep the fi nal step from occurring.