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: M.M. Lloyd, J. Kuyl, H. van Jaarsveld
Format: Article
Language:English
Published: AOSIS 2011-06-01
Series:South African Family Practice
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Online Access:https://safpj.co.za/index.php/safpj/article/view/1632
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author M.M. Lloyd
J. Kuyl
H. van Jaarsveld
author_facet M.M. Lloyd
J. Kuyl
H. van Jaarsveld
author_sort M.M. Lloyd
collection DOAJ
description 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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spelling doaj-art-7faff5b8fff541a4a3926c06b65fbe0b2025-08-20T03:43:47ZengAOSISSouth African Family Practice2078-61902078-62042011-06-0153310.1080/20786204.2011.108741004570Evaluation of point-of-care tests for detecting microalbuminuria in diabetic patientsM.M. Lloyd0J. Kuyl1H. van Jaarsveld2Department of Chemical Pathology, University of Free StateDepartment of Chemical Pathology, University of Free StateDepartment of Chemcal Pathology, University of Free StateBackground: 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.https://safpj.co.za/index.php/safpj/article/view/1632microalbuminuriapoint-of-care testinghemocue®clinitek®urinary albumin excretion
spellingShingle M.M. Lloyd
J. Kuyl
H. van Jaarsveld
Evaluation of point-of-care tests for detecting microalbuminuria in diabetic patients
South African Family Practice
microalbuminuria
point-of-care testing
hemocue®
clinitek®
urinary albumin excretion
title Evaluation of point-of-care tests for detecting microalbuminuria in diabetic patients
title_full Evaluation of point-of-care tests for detecting microalbuminuria in diabetic patients
title_fullStr Evaluation of point-of-care tests for detecting microalbuminuria in diabetic patients
title_full_unstemmed Evaluation of point-of-care tests for detecting microalbuminuria in diabetic patients
title_short Evaluation of point-of-care tests for detecting microalbuminuria in diabetic patients
title_sort evaluation of point of care tests for detecting microalbuminuria in diabetic patients
topic microalbuminuria
point-of-care testing
hemocue®
clinitek®
urinary albumin excretion
url https://safpj.co.za/index.php/safpj/article/view/1632
work_keys_str_mv AT mmlloyd evaluationofpointofcaretestsfordetectingmicroalbuminuriaindiabeticpatients
AT jkuyl evaluationofpointofcaretestsfordetectingmicroalbuminuriaindiabeticpatients
AT hvanjaarsveld evaluationofpointofcaretestsfordetectingmicroalbuminuriaindiabeticpatients