title: Prevalence of microalbuminuria and diagnostic value of dipstick proteinuria in outpatients from HIV clinics in Bukavu, the Democratic Republic of Congo.
abstract: BACKGROUND
  Microalbuminuria is a marker of early kidney disease and high cardiovascular risk in various populations, including HIV positive patients. However, the diagnostic value of qualitative (dipstick) proteinuria and the burden of microalbuminuria in HIV positive patients living in sub-Saharan Africa are relatively unclear.
  
  
  METHODS
  In a cross-sectional study, 235 HIV- positive outpatients were screened for proteinuria in 3 HIV-clinics in Bukavu. A spot urine sample from each subject was tested both by a dipstick and albumin-creatinine-ratio (ACR) assay. The performance of dipstick proteinuria exceeding 1+ was compared with that of microalbuminuria (≥ 30 mg/g creatinine).
  
  
  RESULTS
  The prevalence of microalbuminuria and dipstick proteinuria ≥ (1+), ≥ (2+) and ≥ (3+) was 11%, 41%, 3.5% and 0.7%, respectively.Compared to microalbuminuria, the dipstick (proteinuria of 1+ or greater) had an overall sensitivity of 60% and a specificity of 61%. The positive predictive value was 15.4% and the negative predictive value 92.8%.
  
  
  CONCLUSIONS
  Proteinuria is highly prevalent in HIV positive patients. The limited sensitivity and specificity of the dipstick to detect significant microalbuminuria make it unattractive as a screening tool in HIV positive patients.
authors.affiliation: Department of Medicine, Université Catholique de Bukavu, Bukavu, DR Congo. masimax2003@yahoo.fr.
authors.forename: Mannix Imani
authors.initials: MI
authors.lastname: Masimango
authors.forename: Ernest Kiswaya
authors.initials: EK
authors.lastname: Sumaili
authors.forename: Michel
authors.initials: M
authors.lastname: Jadoul
authors.forename: Pierre
authors.initials: P
authors.lastname: Wallemacq
authors.forename: Dieudonné Kanigula
authors.initials: DK
authors.lastname: Mubagwa
authors.forename: Rissassy Jean-Robert
authors.initials: RJ
authors.lastname: Makulo
authors.forename: François Bompeka
authors.initials: FB
authors.lastname: Lepira
authors.forename: Nazaire Mangani
authors.initials: NM
authors.lastname: Nseka
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000175:diagnosis / Q000453:epidemiology* / Q000652:urine*; D003430:Cross-Sectional Studies; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000652:urine*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011507:Proteinuria / Q000175:diagnosis / Q000453:epidemiology* / Q000652:urine*; D016482:Urinalysis / Q000379:methods / Q000592:standards