Simplified screening for microalbuminuria.
BACKGROUND
Screening for microalbuminuria is increasingly advocated as a way to diagnose early renal involvement in diabetes and other diseases. It usually entails the use of a radioimmunoassay that is expensive and not always readily available.


OBJECTIVE
To assess the efficacy of three simple and inexpensive tests for ruling out microalbuminuria.


METHODS
Cross-sectional study.


METHODS
Outpatient clinics.


METHODS
221 patients from primary care clinics and a diabetes clinic.


METHODS
Random urine specimens were tested for albumin by using Micral-Test immunoassay strips (Boehringer Mannheim, Mannheim, Germany) and for protein by using sulfosalicylic acid testing and impregnated dipsticks (Chemstrips, Boehringer Mannheim). Radioimmunoassay for albumin was used for all specimens as standard for comparison.


RESULTS
When less than 20 mg/L was considered the upper limit of normal for albumin concentration, Micral-Test, sulfosalicylic acid testing, and Chemstrips had negative predictive values of 99%, 95%, and 96%, respectively. Seventy-four specimens tested negative on both sulfosalicylic acid and Chemstrips; the negative predictive value of these two tests combined was 99%.


CONCLUSIONS
The combination of sulfosalicylic acid testing and Chemistrips was as good as and less expensive than Micral-Test in ruling out microalbuminuria.
Pegoraro
A
A
Section of Nephrology, Cook County Hospital, Chicago, IL 60612, USA.
Singh
A
A
Bakir
A A
AA
Arruda
J A
JA
Dunea
G
G
D000419:Albuminuria / Q000175:diagnosis*; D001557:Benzenesulfonates; D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D005189:False Positive Reactions; D006801:Humans; D007118:Immunoassay; D008403:Mass Screening / Q000191:economics / Q000379:methods*; D011237:Predictive Value of Tests; D011934:Reagent Strips; D012459:Salicylates
D001557:Benzenesulfonates; D011934:Reagent Strips; D012459:Salicylates; C003366:sulfosalicylic acid