Utility of a novel point-of-care test for albuminuria in communities at high risk for chronic kidney disease in Thailand

Introduction Chronic kidney disease (CKD) is a major public health concern, and early detection is crucial to prevent adverse outcomes. Albuminuria is an early marker and key prognostic marker in CKD, but reliable tools for its detection are limited particularly in low resource settings. We tested t...

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Main Authors: Aminu K Bello, Kriang Tungsanga, Nattachai Srisawat, Kearkiat Praditpornsilpa, Somkanya Tungsanga, Rungrawee Nantanawijit, Patcharakorn Kiatamornrak, Win Kulvichit, Umphan Ngoensawat, Sasipa Tachaboon, Janejira Dinhuzen, Watchadaporn Chaisuriyong, Kittinan Komolpis, Sadudee Peerapornratana
Format: Article
Language:English
Published: BMJ Publishing Group 2025-01-01
Series:BMJ Public Health
Online Access:https://bmjpublichealth.bmj.com/content/3/1/e001412.full
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author Aminu K Bello
Kriang Tungsanga
Nattachai Srisawat
Kearkiat Praditpornsilpa
Somkanya Tungsanga
Rungrawee Nantanawijit
Patcharakorn Kiatamornrak
Win Kulvichit
Umphan Ngoensawat
Sasipa Tachaboon
Janejira Dinhuzen
Watchadaporn Chaisuriyong
Kittinan Komolpis
Sadudee Peerapornratana
author_facet Aminu K Bello
Kriang Tungsanga
Nattachai Srisawat
Kearkiat Praditpornsilpa
Somkanya Tungsanga
Rungrawee Nantanawijit
Patcharakorn Kiatamornrak
Win Kulvichit
Umphan Ngoensawat
Sasipa Tachaboon
Janejira Dinhuzen
Watchadaporn Chaisuriyong
Kittinan Komolpis
Sadudee Peerapornratana
author_sort Aminu K Bello
collection DOAJ
description Introduction Chronic kidney disease (CKD) is a major public health concern, and early detection is crucial to prevent adverse outcomes. Albuminuria is an early marker and key prognostic marker in CKD, but reliable tools for its detection are limited particularly in low resource settings. We tested the utility of a novel, affordable point-of-care test (POCT) for albuminuria among high-risk individuals for CKD.Methods This is a community-based cross-sectional study covering 17 primary subdistrict healthcare units in Ban Phaeo District, Samut Sakhon Province, Thailand. The inclusion criteria were asymptomatic adult participants diagnosed with hypertension, diabetes and/or aged over 60 years. We measured serum creatinine and quantitative urine albumin–creatinine ratio (UACR) and administered POCT urine albumin strip test (Albii, K. BioSciences, Bangkok, Thailand) and urine dipstick test for protein. Participants with albuminuria or estimated glomerular filtration rate (eGFR) by CKD-EPI 2009 equation <60 mL/min/1.73 m2 were considered to have suspected CKD. We evaluated diagnostic performance of POCT urine albumin strip.Results Among 2307 participants, 489 (20.3%) participants had reduced eGFR and/or albuminuria. The median eGFR was 93.23 (87.82, 98.73) mL/min/m2, and the median UACR was 9.15 (5.09, 20.96) mg/g. The POCT urine albumin strip showed a sensitivity of 0.70, specificity of 0.97 and accuracy of 0.92 compared with the quantitative UACR. Conversely, the POCT urine dipstick for protein had poor sensitivity, positive predictive value and accuracy.Conclusion The urine albumin test strip is a highly effective tool to conduct point-of-care identification for early CKD among high-risk populations. Given the test’s diagnostic performance and ease of use, such test should be incorporated into health policy.
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spelling doaj-art-7a95032a260e42a9881da96e35d9fe8d2025-01-17T08:00:14ZengBMJ Publishing GroupBMJ Public Health2753-42942025-01-013110.1136/bmjph-2024-001412Utility of a novel point-of-care test for albuminuria in communities at high risk for chronic kidney disease in ThailandAminu K Bello0Kriang Tungsanga1Nattachai Srisawat2Kearkiat Praditpornsilpa3Somkanya Tungsanga4Rungrawee Nantanawijit5Patcharakorn Kiatamornrak6Win Kulvichit7Umphan Ngoensawat8Sasipa Tachaboon9Janejira Dinhuzen10Watchadaporn Chaisuriyong11Kittinan Komolpis12Sadudee Peerapornratana13Division of Nephrology and Immunology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada2 Division of Nephrology, Department of Medicine, Faculty of Medicine Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, ThailandChulalongkorn University Faculty of Medicine, Bangkok, ThailandDivision of Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailandpostdoctoral fellowBanphaeo General Hospital, Samut Sakhon, ThailandChulalongkorn University, Bangkok, ThailandDepartment of Medicine, Chulalongkorn University, Bangkok, ThailandThai Red Cross Society, Bangkok, ThailandThai Red Cross Society, Bangkok, ThailandThai Red Cross Society, Bangkok, ThailandThai Red Cross Society, Bangkok, ThailandChulalongkorn University, Bangkok, ThailandThai Red Cross Society, Bangkok, ThailandIntroduction Chronic kidney disease (CKD) is a major public health concern, and early detection is crucial to prevent adverse outcomes. Albuminuria is an early marker and key prognostic marker in CKD, but reliable tools for its detection are limited particularly in low resource settings. We tested the utility of a novel, affordable point-of-care test (POCT) for albuminuria among high-risk individuals for CKD.Methods This is a community-based cross-sectional study covering 17 primary subdistrict healthcare units in Ban Phaeo District, Samut Sakhon Province, Thailand. The inclusion criteria were asymptomatic adult participants diagnosed with hypertension, diabetes and/or aged over 60 years. We measured serum creatinine and quantitative urine albumin–creatinine ratio (UACR) and administered POCT urine albumin strip test (Albii, K. BioSciences, Bangkok, Thailand) and urine dipstick test for protein. Participants with albuminuria or estimated glomerular filtration rate (eGFR) by CKD-EPI 2009 equation <60 mL/min/1.73 m2 were considered to have suspected CKD. We evaluated diagnostic performance of POCT urine albumin strip.Results Among 2307 participants, 489 (20.3%) participants had reduced eGFR and/or albuminuria. The median eGFR was 93.23 (87.82, 98.73) mL/min/m2, and the median UACR was 9.15 (5.09, 20.96) mg/g. The POCT urine albumin strip showed a sensitivity of 0.70, specificity of 0.97 and accuracy of 0.92 compared with the quantitative UACR. Conversely, the POCT urine dipstick for protein had poor sensitivity, positive predictive value and accuracy.Conclusion The urine albumin test strip is a highly effective tool to conduct point-of-care identification for early CKD among high-risk populations. Given the test’s diagnostic performance and ease of use, such test should be incorporated into health policy.https://bmjpublichealth.bmj.com/content/3/1/e001412.full
spellingShingle Aminu K Bello
Kriang Tungsanga
Nattachai Srisawat
Kearkiat Praditpornsilpa
Somkanya Tungsanga
Rungrawee Nantanawijit
Patcharakorn Kiatamornrak
Win Kulvichit
Umphan Ngoensawat
Sasipa Tachaboon
Janejira Dinhuzen
Watchadaporn Chaisuriyong
Kittinan Komolpis
Sadudee Peerapornratana
Utility of a novel point-of-care test for albuminuria in communities at high risk for chronic kidney disease in Thailand
BMJ Public Health
title Utility of a novel point-of-care test for albuminuria in communities at high risk for chronic kidney disease in Thailand
title_full Utility of a novel point-of-care test for albuminuria in communities at high risk for chronic kidney disease in Thailand
title_fullStr Utility of a novel point-of-care test for albuminuria in communities at high risk for chronic kidney disease in Thailand
title_full_unstemmed Utility of a novel point-of-care test for albuminuria in communities at high risk for chronic kidney disease in Thailand
title_short Utility of a novel point-of-care test for albuminuria in communities at high risk for chronic kidney disease in Thailand
title_sort utility of a novel point of care test for albuminuria in communities at high risk for chronic kidney disease in thailand
url https://bmjpublichealth.bmj.com/content/3/1/e001412.full
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