Screening for albumimuria with a self-test or via general practice?

.Schellevis, F., Nielen, M., Verheij, R. Screening for albumimuria with a self-test or via general practice? Abstract. 19th Wonca World Conference 'The Millennium Development Goals. The Contribution of Family Medicine', 19-23 mei 2010, Cancun.
A free self-test for albuminuria was offered in autumn 2006 by the Dutch Kidney Foundation to all Dutch adults. The usefulness of this screening programme was evaluated. A free selft-test consulting of three semi-quantative dipstick test strips could be ordered via the internet. Test results were classified as negative, low positive and high positive. In case of a positive test result, a visit to general practice was recommended for futhrer diagnostic examination. Participants were invited to fill in an on-line questionnaire for evaluation of the programme. During the first month almost 1 million self-tests were ordered. More than 70,0000 participants responded to the questionnaire. A positive test result was reported by 21% (20% low positive and 1% high positive). A quarter of the positive testers visited their GP. Among the 3,983 participants who visited their GP, 25 were newly diagnosed with chronic renal failure, 152 with hypertension and 31 with diabetes mellitus. The screening compaign was successful with repect to the number of ordered tests. A large proportion low positive test results is probably false positive. Only a small part of the positive testers visited their GP from additional examination. Screening for albuminuria via general practice might reduce the number of false positive test results and increase participation in follow-up examinations.