title: Albuminuria is not associated with bacteriuria in patients with type 2 diabetes mellitus: a meta-analysis of observational studies.
abstract: OBJECTIVE
  It has been recommended that urinary albumin be measured in sterile urine for the proper diagnosis of diabetic nephropathy. However, the association between bacteriuria and urinary albumin is controversial.
  
  
  METHODS
  A systematic review and meta-analysis was performed to investigate the association of albuminuria and bacteriuria in patients with diabetes. Medline and Embase were searched (beginning in 1950 until November 2010). Data were extracted independently by two investigators. The pooled OR estimates were calculated using the random effects model.
  
  
  RESULTS
  We identified 305 studies in the database searches. A total of seven studies were included, providing data from 1,552 patients (mean age 56.4 years). The OR of bacteriuria for the presence of micro- and/or macroalbuminuria was 1.60 (95% CI: 0.97-2.66, I(2) = 66.6%) as compared to patients without bacteriuria. Funnel plots and the Egger regression test suggested no significant asymmetry in the analysis (p = 0.21). In a sensitivity analysis including the five studies (1,197 participants) that evaluated microalbuminuria as the outcome, the OR of bacteriuria for microalbuminuria was 1.22 (95% CI: 0.68-2.19).
  
  
  CONCLUSIONS
  In conclusion, no association was identified between albuminuria and bacteriuria considering the current literature. Further prospective studies of a large diabetic population are needed to clarify such an association.
authors.affiliation: Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. carolinekkramer@gmail.com
authors.forename: Caroline K
authors.initials: CK
authors.lastname: Kramer
authors.forename: Mirela J
authors.initials: MJ
authors.lastname: Azevedo
authors.forename: Gabriela
authors.initials: G
authors.lastname: Teló
authors.forename: Jorge L
authors.initials: JL
authors.lastname: Gross
mesh_terms: D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000453:epidemiology*; D016477:Artifacts; D001437:Bacteriuria / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000652:urine*; D003928:Diabetic Nephropathies / Q000175:diagnosis* / Q000453:epidemiology / Q000652:urine; D004198:Disease Susceptibility; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008875:Middle Aged; D009391:Nephelometry and Turbidimetry; D016017:Odds Ratio; D015995:Prevalence; D011446:Prospective Studies; D017594:Publication Bias; D011863:Radioimmunoassay; D011934:Reagent Strips; D012307:Risk Factors; D012680:Sensitivity and Specificity
chemical_list: D006442:Glycated Hemoglobin; D011934:Reagent Strips