Albuminuria/Proteinuria in Cardiology Practice: Do Cardiologists Ask For Urine Testing?

OBJECTIVE: Even a small amount of albumin in urine is predictive of cardiovascular morbidity and mortality, not only in patients with diabetes or hypertension but also in the general population. We hypothesized that determination of urinary protein excretion is usually not included in the laboratory work-up of most patients in cardiology practice. MATERIAL and METHODS: One thousand forty two patients who underwent coronary angiography during a one-year period were included. The total number of urine tests for evaluating albuminuria/ proteinuria ordered for the patients during the 12 months preceding angiography was recorded. Types of urine tests were recorded as routine dipstick urinalysis, 24 hour urine collection for albuminuria or proteinuria, and protein/creatinine or albumin/creatinine ratios. RESULTS: No urine tests were ordered in 642 (61.6%) patients. Spot urinalysis for dipstick proteinuria was the most common test for proteinuria evaluation (35.7% of the patients). 24-hour urine collection for albuminuria/proteinuria was ordered in 56 (5.4%) patients and spot urine albumin or protein/ creatinine ratio in 56 (5.4%) patients. CONCLUSION: This study has shown that urine testing is rarely ordered in a high-risk population who had coronary angiography. Omission of such an important, but easy to measure parameter in assessing risk status may jeopardize the overall care of these patients.