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Background: Urinalysis is not a standard component of health screening in the elderly population., Objective: We investigated the prevalence and risk factors of undetected renal disease as defined by proteinuria (PR) in an elderly South-East Asian population., Method: There were 19,848 participants of age >or=65 years in National Kidney Foundation's Nationwide Screening programme at Singapore. Mean age was 70.6 +/- 5.3 years. After excluding the 1.1% who had pre-existing renal disease, 8.5% were identified to have previously undetected PR defined as >or=1+ protein on urine dipstick analysis. Multivariate regression revealed that male gender (OR = 1.2, reference category (Ref): female), known diabetes (odds ratio (OR) = 2.28; P < 0.0001), hypertension (OR = 1.62; P = 0.0001), presence of elevated blood pressure (BP) (>or=120/90 mmHg) on screening (OR = 1.38, 1.89, 3.45 for mild, moderate and severe BP, respectively, all P < 0.0001), elevated body mass index (BMI) (OR = 1.3 for BMI >or=23 vs BMI < 23 kg/m(2)), and smoking (OR = 1.2, ref: non-smokers) were significantly associated with PR. Finally, a progressive increase in OR for PR was observed with stepwise increase in age (years) (OR for 67-68.9: 1.2, P = 0.025; 69-72.9, 1.49, P = 0.49; >or=73: 1.56, P < 0.0001, Ref: 65-66.9 years)., Conclusion: We conclude that there is high prevalence of previously undetected proteinuria in elderly South-East Asians. Because proteinuria is a risk factor for cardiovascular disease, our findings support inclusion of urinalysis in routine health screening for this population.