A review of albuminuria testing rates in people with diabetes mellitus: poor guideline adherence.

Diabetes mellitus and chronic kidney disease (CKD) are prevalent conditions affecting a significant portion of the Australian population. Urinary albumin testing, particularly through the urine albumin-to-creatinine ratio (uACR), is essential for screening, prognostication, and guiding treatment in patients with diabetes and CKD. Despite recommendations for annual screening among high-risk populations such as those with diabetes, recent studies indicate disturbingly low rates of albuminuria testing. This narrative literature review aims to examine rates of uACR testing in these populations, focusing on recent studies across various clinical settings and geographical regions. A systematic search was conducted using Ovid MEDLINE, PubMed, and the Cochrane Library, yielding 13 observational studies published from 2016 onward. These studies consistently reported suboptimal uACR testing rates, ranging from 1.5% to 76.6%, with populations affected by diabetes demonstrating testing rates generally below 50%. The review highlights the global issue of low adherence to testing guidelines and emphasises the need for improved clinical practices and policy incentives to enhance uACR testing.