Albumin excretion rate, albumin concentration, and albumin/creatinine ratio compared for screening diabetics for slight albuminuria.
Slight albuminuria, an overnight albumin excretion rate (AER) greater than 30 micrograms/min in an "Albustix"-negative sample, predicts development of diabetic nephropathy. This study compares the AERs for 261 timed overnight urine collections with the albumin concentrations and albumin/creatinine ratios for the same specimens (equivalent to first morning specimens). Thirty-one specimens (11.9%) had AERs greater than 30 micrograms/min. Use of an albumin/creatinine ratio greater than 3.0 mg/mmol to predict an AER greater than 30 micrograms/min gave a sensitivity of 96.8%, a specificity of 93.9%, and a predictive value of 68.2%, with a correlation coefficient of 0.921. Use of an albumin concentration greater than 17 mg/L gave a sensitivity of 96.8%, a specificity of 90.9%, a predictive value of 58.8%, and a slightly poorer correlation (r = 0.904). Evidently either method is acceptable as an initial screening procedure, but determination of albumin concentration alone would be preferable because of lesser cost.
Hutchison
A S
AS
Biochemistry Department, Southern General Hospital, Glasgow, Scotland.
O'Reilly
D S
DS
MacCuish
A C
AC
D000419:Albuminuria / Q000652:urine*; D003404:Creatinine / Q000652:urine*; D003928:Diabetic Nephropathies / Q000652:urine*; D006801:Humans; D011933:Reagent Kits, Diagnostic
D011933:Reagent Kits, Diagnostic; D003404:Creatinine