Evaluation of point-of-care tests for detecting microalbuminuria in diabetic patients
Background: Microalbuminuria, the presence of low levels of albumin in the urine, indicates renal damage and is recognised as a risk factor for the progression of renal and cardiovascular disease. Several international scientific bodies recommend microalbuminuria screening. Point-of-care testing (PO...
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| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
AOSIS
2011-06-01
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| Series: | South African Family Practice |
| Subjects: | |
| Online Access: | https://safpj.co.za/index.php/safpj/article/view/1632 |
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| Summary: | Background: Microalbuminuria, the presence of low levels of albumin in the urine, indicates renal damage and is recognised as a risk factor for the progression of renal and cardiovascular disease. Several international scientific bodies recommend microalbuminuria screening. Point-of-care testing (POCT) of microalbuminuria allows immediate identification of risk, and monitoring of treatment effects. In this study, two POCT instruments were evaluated as microalbuminuria screening methods.
Method: Spot urine specimens from diabetic patients were analysed with the quantitative HemoCue® urine albumin analyser (n = 245), and the semiquantitative Clinitek® microalbumin urine dipstick (n = 204). These results were compared to the respective data for laboratory-determined albumin (nephelometry), creatinine (modified Jaffe) and albumin-to-creatinine ratio (ACR).
Results: Linear regression analysis demonstrated a good correlation for the HemoCue® urine albumin with the laboratorydetermined albumin concentration (y = 0.8557x + 0.2487y, r = 0.97). The sensitivities for the HemoCue® and Clinitek® POCT systems were 79.6% and 83.8%, and the specificities 97.1% and 93.8% respectively. Positive and negative predictive values for the HemoCue® were 95.6% and 85.8%, and were 88.6% and 91.0% the Clinitek®. The repeatability of both instruments was excellent. Both instruments are easy to use, and more cost-effective than the laboratory methods for albumin and ACR.
Conclusion: Both the HemoCue® and the Clinitek® microalbumin POCT systems for albuminuria are easy to use and inexpensive, and are adequately accurate as a screening method. Although the HemoCue® POCT system measures only urine albumin concentration, its sensitivity and specificity compared well with that of the Clinitek® POCT system, which determines the ACR. |
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| ISSN: | 2078-6190 2078-6204 |