Diagnostic accuracy of urine dipstick for proteinuria in older outpatients

BACKGROUND: The urine dipstick is widely used as an initial screening tool for the evaluation of proteinuria; however, its diagnostic accuracy has not yet been sufficiently evaluated. Therefore, we evaluated its diagnostic accuracy using spot urine albumin/creatinine ratio (ACR) and total protein/cr...

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Detalles Bibliográficos
Autores principales: Lim, Dongmin, Lee, Dong-Young, Cho, Soung Ha, Kim, One Zoong, Cho, Sang Woo, An, Su Kyoung, Kim, Hwe Won, Moon, Kyoung Hyoub, Lee, Myung Hee, Kim, Beom
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4714264/
https://www.ncbi.nlm.nih.gov/pubmed/26885477
http://dx.doi.org/10.1016/j.krcp.2014.10.003
Descripción
Sumario:BACKGROUND: The urine dipstick is widely used as an initial screening tool for the evaluation of proteinuria; however, its diagnostic accuracy has not yet been sufficiently evaluated. Therefore, we evaluated its diagnostic accuracy using spot urine albumin/creatinine ratio (ACR) and total protein/creatinine ratio (PCR) in proteinuria. METHODS: Using PCR ≥0.2 g/g or ≥0.5 g/g and ACR ≥300 mg/g or ≥30 mg/g as the reference standard, we calculated the diagnostic accuracy profile: sensitivity, specificity, positive and negative predictive value, and the area under the curve (AUC) of the receiver operating characteristic curve. RESULTS: PCR and ACR were available for 10,348 and 3,873 instances of dipstick testing. The proportions with PCR ≥0.2 g/g, ≥0.5 g/g and ACR ≥300 mg/g, ≥30 mg/g were 38.2%, 24.6% and 8.9%, 31.7%, respectively. The AUCs for PCR ≥0.2 g/g, ≥0.5 g/g, and ACR ≥300 mg/g were 0.935 (trace: closest to ideal point), 0.968 (1+), and 0.983 (1+), respectively. Both sensitivity and specificity were >80% except for PCR ≥0.5 g/g with trace cutoff. For the reference standard of ACR ≥30 mg/g, the AUC was 0.797 (trace) and the sensitivity was 63.5%. CONCLUSION: Urine dipstick test can be used for screening in older outpatients with ACR ≥300 mg/g or PCR as the reference standard for proteinuria. However, we cannot recommend the test as a screening tool with ACR ≥30 mg/g as the reference owing to its low sensitivity.