Srpski arhiv za celokupno lekarstvo 2012 Volume 140, Issue 3-4, Pages: 173-178
https://doi.org/10.2298/SARH1204173D
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Evaluation of methods for rapid microalbuminuria screening in kidney diseased patients
Dajak Marijana (Centar za medicinsku biohemiju, Klinički centar Srbije, Beograd)
Bontić Ana (Klinika za nefrologiju, Klinički centar Srbije, Beograd)
Ignjatović Svetlana (Centar za medicinsku biohemiju, Klinički centar Srbije, Beograd + Farmaceutski fakultet, Beograd)
Pavlović Jelena (Klinika za nefrologiju, Klinički centar Srbije, Beograd)
Majkić-Singh Nada (Centar za medicinsku biohemiju, Klinički centar Srbije, Beograd + Farmaceutski fakultet, Beograd)
Ležaić Višnja (Klinika za nefrologiju, Klinički centar Srbije, Beograd + Medicinski fakultet, Beograd)
Introduction. One of the criteria for chronic kidney disease detection is
determination of microalbuminuria. Objective. This analysis was performed to
evaluate accuracy of three useful methods for microalbuminuria detection in
24h urine collection and in the morning urine specimen calculated from urine
albumin creatinine ratio, or with a dipstick in patients with different
kidney diseases or kidney function. Methods. Microalbuminuria was detected in
74 patients referred to the Outpatient Nephrology Department for kidney
function determination or regular nephrology checking. Albumin concentration
determined using immunonephelometry was lower than 300 mg/day. Discriminates
cutoff values for spot urine test strip and albumin creatinin ratio in
predicting 24 h protein ‘threshold’ excretion were determined using ROC
analysis. Results. Mean value of 24 h microalbuminuria was 80.3 mg/24 h, and
value >30 mg/24 h was present in 71.8% of patient. Correlation coefficients
between dipstick microalbuminuria or albumin/creatinine ratio in a spot urine
specimen and 24 h microalbuminuria were 0.709 and 0.598 (p<0.0001). For
pathological value of 24 h microalbuminuria >30 mg/24 h, the coresponding
dipstick microalbuminuria value was ≥20 mg/L (AUC 0.849, specificity 95%,
positive predictive value 97.3%), and ≥3.55 mg albumin/mmol creatinine ratio
(AUC 0.914, specificity 90% and positive predictive value 95.5%). No
difference was found between dipstick mikroalbuminuria and albumin/creatinine
ratio value. In addition, albumin/creatinine ratio value from 24 h urine was
similar to the value obtained from the spot urine sample. Conclusion.
Obtained results indicated that albuminuria could be determined accurately in
spot urine either with the Micral test strip or with albumin creatinine
ratio.
Keywords: microalbuminuria, test strip, urine albumin creatinine ratio, accuracy of methods