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KMID : 0359920140330040199
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Korean Journal of Nephrology
2014 Volume.33 No. 4 p.199 ~ p.203
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Diagnostic accuracy of urine dipstick for proteinuria in older outpatients
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Lim Dong-Min
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
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Abstract
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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 Z0.2 g/g or Z0.5 g/g and ACR Z300 mg/g or Z30 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 Z0.2 g/g, Z0.5 g/g and ACR Z300 mg/g, Z30 mg/g were 38.2%, 24.6% and 8.9%, 31.7%, respectively. The AUCs for PCR
Z0.2 g/g, Z0.5 g/g, and ACR Z300 mg/g were 0.935 (trace: closest to ideal point), 0.968 (1þ), and 0.983 (1þ), respectively. Both sensitivity and specificity were 480% except for PCR Z0.5 g/g with trace cutoff. For the reference standard of ACR
Z30 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 Z300 mg/g or PCR as the reference standard for proteinuria. However, we cannot recommend the test as a screening tool with ACR Z30 mg/g as the reference
owing to its low sensitivity.
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KEYWORD
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Albuminuria, Proteinuria, Reagent strips, ROC curve
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