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Open Access Research article

The usefulness of a free self-test for screening albuminuria in the general population: a cross-sectional survey

Markus MJ Nielen1*, François G Schellevis12 and Robert A Verheij1

Author Affiliations

1 NIVEL (Netherlands Institute for Health Services Research), P.O. Box 1568, 3500BN Utrecht, The Netherlands

2 Department of General Practice/EMGO Institute, VU University Medical Center, Amsterdam, The Netherlands

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BMC Public Health 2009, 9:381  doi:10.1186/1471-2458-9-381

Published: 9 October 2009

Abstract

Background

In this study we evaluated the usefulness of a free self-test for screening albuminuria in the general population.

Methods

Dutch adults were invited by the Dutch Kidney Foundation to order a free albuminuria self-test, consisting of three semi quantitative dipstick tests, via the Internet. Results were classified in negative, low-positive and high-positive. In case of a positive test result, the tester was recommended to visit a GP for supplementary examination and/or treatment. Participants of the programme were sent a questionnaire for evaluation by e-mail eight weeks after receiving the self-test.

Results

During the first 30 days of the self-test programme, 996,927 self-tests were ordered. In total, 71,714 participants completed the questionnaire: 79% had a negative test result and 21% had a positive test result (20% low-positive and 1% high-positive). Of the positive testers, 25% visited a GP after testing for albuminuria. Among the 3,983 participants who visited a GP, 193 new diseases were detected: 25 chronic renal failure, 152 hypertension and 31 diabetes mellitus.

Conclusion

Using a free self-test for screening albuminuria in the general population resulted in a large response and a number of newly detected diseases. However, we found a very high percentage of positive testers of which probably a large part is false positive. Furthermore, only a small part of the positive testers visited a GP for additional examination and/or treatment. The efficiency of such a campaign could be increased by embedding the testing in health care to reduce the number of false-positive results and to ensure follow-up and treatment in case of a positive test result.