Diagnostic accuracy of urine dipstick for proteinuria in older outpatients

• Main Authors: Dongmin Lim (Author), Dong-Young Lee (Author), Soung Ha Cho (Author), One Zoong Kim (Author), Sang Woo Cho (Author), Su Kyoung An (Author), Hwe Won Kim (Author), Kyoung Hyoub Moon (Author), Myung Hee Lee (Author), Beom Kim (Author)
• Format: Book
• Published: The Korean Society of Nephrology, 2014-12-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

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.

Item Description

2211-9132
10.1016/j.krcp.2014.10.003