[Evaluation of two rapid tests for the determination of microalbuminuria and the urinary albumin/creatinine ratio].
OBJECTIVE
Microalbuminuria screening is justified on the grounds of its cost-benefit ratio in patients at risk of kidney damage while the process is still reversible. The aim of the present study was to evaluate the DCA 2000 analyser and the Clinitek 50 system (Bayer), which simultaneously measure urinary albumin and creatinine levels to adopt them as rapid methods for microalbuminuria detection.


METHODS
One hundred twenty-seven urine samples from pediatric patients with various disorders were assessed. Albumin, creatinine, and the albumin/creatinine ratio were determined using the DCA 2000 analyzer and the Clinitek 50 system, which were compared against the usual reference laboratory methods.


RESULTS
The correlation coefficient of nephelometric values vs the DCA 2000 analyzer was 0.914 for albumin, 0.970 for creatinine and 0.839 for the albumin/creatinine ratio. At an albumin cut-off concentration of 30 mg/l, the sensitivity, specificity, positive predictive value and negative predictive value were 100 %, 93 %, 84 % and 100 % for the DCA 2000 analyzer and 91.7 %, 86 %, 55 % and 98 % for the Clinitek 50 system. ROC curve analysis showed that the DCA 2000 system was more effective than the Clinitek 50 in microalbuminuria screening.


CONCLUSIONS
The data obtained with the DCA 2000 system showed close agreement with those obtained with reference laboratory methods. The immediate availability of results is a great advantage in clinical practice. The Clinitek-Microalbumin dipstick system is a semiquantitative method that is easy to use, low in cost, simple and useful for screening, but it is less reliable as a follow-up method.
Osta
V
V
Laboratorio Central. Hospital de Niños Dr. Ricardo Gutiérrez. Buenos Aires. Argentina. viosta@ciudad.com.ar
Natoli
V
V
Diéguez
S
S
D000293:Adolescent; D000328:Adult; D000418:Albumins / Q000378:metabolism*; D000419:Albuminuria / Q000175:diagnosis* / Q000191:economics / Q000652:urine*; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D003404:Creatinine / Q000652:urine*; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000175:diagnosis / Q000191:economics / Q000652:urine; D008297:Male; D009391:Nephelometry and Turbidimetry / Q000295:instrumentation
D000418:Albumins; D003404:Creatinine