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Why 24-h Urine Albumin Excretion Rate Method Still is Used for Screening of Diabetic Nephropathy in Isfahan Laboratories?
Abstract
Background:The first step in diagnosis of diabetic nephropathy is measurement ofalbumin in a spot urine sample. The aim of this study was assessment of the accuracy of urinary albumin to creatinine ratio (UACR) in random urine specimens (RUS) for microalbuminuria and macroalbuminuria screening in Iranian diabetic patients.
Methods:A total of 200 diabetic patients participated to our study. 24 h timed urine specimens followed by RUS were collected. 24-h urine albumin excretion (24-h urinary albumin excretion (UAE)) and UACR in RUS were measured. Data were analyzed by Pearson’s correlation, receiver operating characteristic (ROC) curve and McNemar test.
Results:A total of 165 patients finalized the study. Pearson’s
correlation ofcoefficient for 24-h UAE versus UACR was 0.64. The area under ROC curve for UACR was 0.83 in microalbuminuria
and 0.91 in macroalbuminuria. The cutoff point of 30 mg/g in UACR method had 86% sensitivity and 60% specificity for microalbuminuria screening and cut-off point of 300 mg/g
had 75% sensitivity and 99% specificity for macroalbuminuria
screening respectively.
Conclusions:UACR in RUS showed acceptable performance as a screening test for diagnosis ofboth micro and macroalbuminuria in Iranian diabetic patients.
Keywords:Albuminuria, diabetic nephropathy, screening, urinary albumin to creatinine ratio
Methods:A total of 200 diabetic patients participated to our study. 24 h timed urine specimens followed by RUS were collected. 24-h urine albumin excretion (24-h urinary albumin excretion (UAE)) and UACR in RUS were measured. Data were analyzed by Pearson’s correlation, receiver operating characteristic (ROC) curve and McNemar test.
Results:A total of 165 patients finalized the study. Pearson’s
correlation ofcoefficient for 24-h UAE versus UACR was 0.64. The area under ROC curve for UACR was 0.83 in microalbuminuria
and 0.91 in macroalbuminuria. The cutoff point of 30 mg/g in UACR method had 86% sensitivity and 60% specificity for microalbuminuria screening and cut-off point of 300 mg/g
had 75% sensitivity and 99% specificity for macroalbuminuria
screening respectively.
Conclusions:UACR in RUS showed acceptable performance as a screening test for diagnosis ofboth micro and macroalbuminuria in Iranian diabetic patients.
Keywords:Albuminuria, diabetic nephropathy, screening, urinary albumin to creatinine ratio