Graduation Semester and Year
Fall 2026
Language
English
Document Type
DNP Project
Degree Name
Doctor of Nursing Practice
Department
Nursing
First Advisor
Kellie Kahveci, PhD, AGPCNP-BC, GNP-BC
Abstract
Introduction
Microalbuminuria is an early indicator of Chronic Kidney Disease (CKD). Hypertension (HTN) is one of the leading causes of CKD. Early treatment of CKD can delay and even prevent progression to End Stage Renal Disease (ESRD). Monitoring patients with HTN more frequently for microalbuminuria can identify CKD earlier than annual screening so that treatment can be initiated sooner to offer greater protection of the kidneys over time.
Background
In a small, rural clinic, it was determined that Urine Microalbumin (UMA) screening in office was not being done, but has been shown to be beneficial in identifying CKD. Current practice for this facility was annual glomerular filtration rate (GFR) and urine microalbumin-creatinine ratio (UACR) was done on hypertensive patients annually. The Renal Protection Plan was completed to determine if adding additional UMA screenings in office would identify more patients with CKD than annual screening alone.
Methods
Written education was provided to patients with HTN regarding lifestyle changes to provide renal protection. Pharmaceutical options, including the addition of sodium-glucose co-transporter-2 (SGLT-2) inhibitors were discussed for both treatment and prevention. UMA screening was done on every agreeable patient at every visit. Data was reviewed to determine if CKD diagnosis increased from previous methods using retrospective data to compare.
Results
A two-fold increase in CKD diagnosis was noted after implementation. Ninety-nine percent of patients participated in lifestyle and pharmaceutical education. Lastly, using a decision-tree with shared decision making, 11.5% of patients opted in to treatment with an SGLT-2.
Conclusion
The implementation of the Renal Protection Plan Bundle demonstrated positive results in screening for CKD. The bundle included succinct education for patients with hypertension, and provided opportunity to discuss additional options for treatment and prevention of CKD.
Keywords
Microalbumin, Microalbuminuria, Hypertension, Chronic kidney disease, SGLT-2.
Disciplines
Family Medicine | Family Practice Nursing | Medical Pharmacology
License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Recommended Citation
Votaw, Nicole C., "Microalbumin Screening in Hypertension: An Evidence Based Implementation" (2026). Doctor of Nursing Practice (DNP) Scholarly Projects. 25.
https://mavmatrix.uta.edu/nursing_dnpprojects2/25