Mp153the Importance of Urine Specific Gravity Measurement in Urine Dipstick Testing

Kamimura, Taro; Fukumitsu, Kento; Aihara, Seishi; Kondo, Mio; Oka, Hideaki; Harada, Atsumi

doi:10.1093/ndt/gfx164.mp153

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“…Finally, due to the variability of albuminuria during the day, the random collection of urine samples could skew the prevalence rate [ 45 ], but this should not influence the finding of the concordance and agreement between index and reference tests. Both semiquantitative urine dipstick tests are dependent on urine concentration and the urine specific gravity [ 46 ], which was not assessed in our laboratory. Further, the albuminuria screening algorithm models were built under the assumption that we detected patients with persistent and not transient albuminuria.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Two Different Semiquantitative Urinary Dipstick Tests with Albumin-to-Creatinine Ratio for Screening and Classification of Albuminuria According to KDIGO. A Diagnostic Test Study

et al. 2021

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Background: Semiquantitative dipstick tests are utilized for albuminuria screening. Methods: In a prospective cross-sectional survey, we analyzed the diagnostic test validity of the semiquantitative colorimetric indicator-dye-based Combur9-Test® and the albumin-specific immunochromatographic assay Micral-Test® for the detection of albuminuria, the distribution of the semiquantitative measurements within the albuminuria stages according to KDIGO, and the utility for albuminuria screening compared with an albumin-to-creatinine ratio (ACR) in a walk-in population. Results: In 970 subjects, albuminuria (≥30 mg/g) was detected in 12.7% (95% CI 85.6–96.3%) with the ACR. Sensitivity was 82.9% (95% CI 75.1–89.1%) and 91.9% (95% CI 88.7–96.9%) and specificity 71.5% (95% CI 68.4–74.6%) and 17.5% (95% CI 15.0–20.2%) for the Combur9-Test® and Micral-Test®, respectively. Correct classification to KDIGO albuminuria stages A2/A3 with the Combur9-Test® was 15.4%, 51.4%, and 87.9% at cut-offs of 30, 100, and ≥300 mg/dL, and with the Micral-Test® it was 1.8%, 10.5%, and 53.6% at cut-offs of 2, 5, and 10 mg/dL, respectively. Overall, disagreement to KDIGO albuminuria was seen in 27% and 73% with the Combur9-Test® and Micral-Test®, respectively. From the total population, 62.5% and 15.3% were correctly ruled out and 2.2% and 1% were missed as false-negatives by the Combur9-Test® and Micral-Test®, respectively. Conclusion: Compared to the Combur9-Test®, the utility of the Micral-Test® is limited, because the fraction of correctly ruled out patients is small and a large proportion with a positive Micral-Test® require a subsequent ACR conformation test.

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Section: Discussionmentioning

confidence: 99%