# UACR-screening onderbenut bij diabetes en hypertensie in de huisartsenpraktijk

*geplaatst 2026-09-13 · Nierziekte · Canadian journal of diabetes · doi 10.1016/j.jcjd.2026.08.185 · https://hartvaat.nl/2026/09/04/uacr-screening-onderbenut-bij-diabetes-en-hypertensie-in-de-huisartsenpraktijk/*

Een real-world studie onder 4.456 volwassenen met diabetes en hypertensie toont aan dat het screenen van cardiovasculaire en nierfunctie in de huisartsenpraktijk aanzienlijk onderbenut blijft. Slechts 32% van de patiënten had een UACR-bepaling, terwijl 20% een chronische nierziekte had en 54% een LDL-C ≥ 2,0 mmol/L. Ongecontroleerde bloeddruk ging gepaard met meer albuminurie en dyslipidemie. Consistente screening kan helpen om tijdig patiënten te identificeren die baat hebben bij richtlijnconforme antiproteinurische en lipiddalingstherapie.

## English: Historical Gaps in Kidney and Cardiovascular Risk Assessment Among Patients with Diabetes and Hypertension: A Real-World Primary Care Study.

A real-world analysis of 4,456 adults with diabetes and hypertension reveals substantial gaps in cardiovascular and renal risk screening in primary care. Only 32% had a urine albumin-to-creatinine ratio (UACR) test, while 20% had chronic kidney disease and 54% had suboptimal LDL-C levels (≥2.0 mmol/L). Uncontrolled blood pressure was associated with higher rates of albuminuria and dyslipidemia. Routine screening could identify high-risk patients earlier, enabling timely initiation of guideline-directed antiproteinuric and lipid-lowering therapies.

## Abstract (original, from the publication)

INTRODUCTION: Individuals with both diabetes and hypertension are at high risk for micro- and macrovascular complications, underscoring the importance of regular monitoring of HbA1C, cholesterol, urine albumin-to-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR). METHODS: We analyzed laboratory tests from 4,456 adults from primary care practices with diabetes and hypertension, each with at least two blood pressure measurements between January 1, 2013, and December 31, 2017, and at least one test (HbA1C, UACR, eGFR, and LDL-C) within two years. Test completion rates and results were reported across three blood pressure categories: controlled (<130mmHg/<80mmHg), stage 1 hypertension (130-139mmHg/80-89mmHg), and stage 2 hypertension (≥140mmHg/≥90mmHg). RESULTS: Of the 4,456 individuals, 86% had HbA1C tested, 32% had UACR, 76% had eGFR, and 83% had LDL-C. Among those tested, 43% had HbA1c >7.0%, 11% had macroalbuminuria (UACR >20mg/mmol), 20% had chronic kidney disease (CKD) (eGFR <60mL/min/1.73m2), and 54% had dyslipidemia (LDL-C ≥2.0mmol/L). Those with stage 2 hypertension had higher rates of albuminuria, CKD, and dyslipidemia compared to those with controlled or stage 1 hypertension. CONCLUSIONS: Our study has three key findings. UACR testing was underutilized among patients with diabetes and hypertension. Consistent screening could have identified individuals who would benefit from guideline directed antiproteinuric therapies. Uncontrolled blood pressure was associated with higher rates of albuminuria and dyslipidemia. Achievement of LDL-C < 2.0 mmol/L was suboptimal, in over 50% of patients, necessitating improved cardiovascular risk management in this high-risk group.

Auteurs: Jian Roushani, Sachin V Pasricha, Lisa Dubrofsky, Bailey Goldman, Laura O'Driscoll, Shane Golden, Brad Millson, Sheldon W Tobe

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Bron: Canadian journal of diabetes, https://doi.org/10.1016/j.jcjd.2026.08.185. Bijgewerkt 2026-09-06T01:04:04Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.