On May 28, 2024, in the Opinion Section, WSJ ran an article titled “Bureaucrats vs. Kidney Patients” by The Editorial Board. Below is a 250-word condensed version of the article followed by information from Perplexity on just what the tests are that are highlighted in the article. I previously did not know such tests existed.
In August 2023, the National Committee for Quality Assurance (NCQA) removed an at-home kidney test from its list of approved tests, denying patients an easy way to check their risk for kidney disease. The convenient semi-quantitative test uses a urine sample to measure albumin, an early indicator of kidney problems.
NCQA claims the test was “erroneously misclassified” as a lab test, but this seems like bureaucratic confusion. Both the American Diabetes Association and the National Kidney Foundation have endorsed home tests to improve access, especially for rural patients. Eliminating this option will “take us backward rather than forward,” says Dr. George Bakris, who co-authored the guidelines.
Kidney disease often goes undiagnosed until it has caused substantial damage. Over 37 million Americans have chronic kidney disease, and 90% are unaware. Frequent testing is crucial, especially for the 38.4 million Americans with diabetes, a third of whom have kidney disease. Early detection can prevent the need for dialysis, which costs Medicare over $153 billion annually.
While NCQA acknowledges home tests may play a role in the future, they already serve an important purpose. This decision appears to prioritize cost and bureaucratic control over patient needs. Doctors and patients are now pushing back, arguing that easy access to screening is vital for catching kidney issues early and improving outcomes.
Home kidney test kits can provide a semi-quantitative detection of small quantities of albumin in urine, which is an indicator of potential kidney disease. The Accu-Tell Microalbumin Semi-quantitative Rapid Test Strip is designed to detect albumin levels between 20-100 mg/L by showing varying color intensities on the test strip. Similarly, the Healthy.io Minuteful Kidney kit uses a urine dipstick and smartphone app to rapidly detect albumin levels, though it does not provide detailed results. These semi-quantitative tests can help screen for microalbuminuria, an early sign of kidney damage, but positive results should be confirmed with further quantitative testing by a doctor.
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