March 24/31, 2004

Cost-effectiveness of Screening for Proteinuria

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291(12):1442-1443. doi:10.1001/jama.291.12.1442

To the Editor: Dr Boulware and colleagues1 concluded that a strategy of annual dipstick screening for proteinuria with follow-up testing and treatment with an angiotensin-converting enzyme (ACE) inhibitor would not be cost-effective to slow progression of kidney disease or to decrease mortality. We believe that their results were strongly influenced by a number of factors, including the low yield of the screening test, the high costs for the screening by the primary care physician, and the possible added reduction of cardiovascular morbidity that is not taken into account.

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