title: Use of a first-line urine protein-to-creatinine ratio strip test on random urines to rule out proteinuria in patients with chronic kidney disease.
abstract: BACKGROUND
  Urine protein strip tests are often used in the ward or clinic as first-line measures of proteinuria. The ability of a semi-quantitative meter-read strip test for the protein:creatinine ratio, Multistix* PRO 10LS (Siemens Medical Solutions, Tarrytown, USA), was assessed as a first-line test to exclude significant proteinuria in the monitoring of patients with established chronic kidney disease.
  
  
  METHODS
  Eighty-six patients attending a hospital renal outpatient clinic collected three random urine samples during a 24-h period. Random urine protein:creatinine ratios measured by the strip test were compared to the laboratory estimation of 24-h protein excretion on that same day.
  
  
  RESULTS
  At significant protein excretion of 0.3 g/24 h, the strips elicited negative predictive values in the range of 91.2-94.1% and negative likelihood ratios of 0.01-0.12, using all the random urines. Receiver-operator characteristic curve analysis also demonstrated good performance with all samples.
  
  
  CONCLUSIONS
  The strip test allows the physician to rule out significant proteinuria at the patient consultation on a random urine sample, obviating the need for specially collected samples, and with the added benefit of reducing the need for a lengthy and costly quantitative laboratory follow-up by approximately 40-48%.
authors.affiliation: Department of Clinical Biochemistry, Salford Royal NHS Foundation Trust, Salford, UK. mark.guy@srft.nhs.uk
authors.forename: Mark
authors.initials: M
authors.lastname: Guy
authors.forename: Ronald
authors.initials: R
authors.lastname: Newall
authors.forename: Joanna
authors.initials: J
authors.lastname: Borzomato
authors.forename: Philip A
authors.initials: PA
authors.lastname: Kalra
authors.forename: Christopher
authors.initials: C
authors.lastname: Price
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003404:Creatinine / Q000652:urine; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D011237:Predictive Value of Tests; D011507:Proteinuria / Q000175:diagnosis* / Q000209:etiology; D011934:Reagent Strips
chemical_list: D011934:Reagent Strips; D003404:Creatinine