A Dipstick Protein and Specific Gravity Algorithm Accurately Predicts Pathological Proteinuria

Constantiner, Marigel; Sehgal, Ashwini R.; Humbert, Lisa; Constantiner, Daniel; Arce, Lillian; Sedor, John R.; Schelling, Jeffrey R.

doi:10.1053/j.ajkd.2005.02.012

Cited by 38 publications

(39 citation statements)

References 29 publications

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“…In the general population, DSP has been shown to be a sensitive, but rather nonspecific test for both clinical proteinuria and microalbuminuria. 4,5 In our study, the opposite is true for SCI patients in whom DSP is very specific, but not sensitive for the detection of clinical proteinuria. There are at least two possible explanations for the lack of sensitivity.…”

Section: Discussionmentioning

confidence: 67%

“…13 Chronic SCI patients also have clinical characteristics that may decrease the accuracy of DSP and UPC in detecting and quantifying proteinuria. These factors include dilute urine 4 and high rates of urinary tract inflammation, which may lead to increased levels of non-albuminuric proteins. 14,15 As urine dipsticks are more reactive to albumin than non-albumin proteins, 16 dipstick analysis may not be as sensitive in predicting total proteinuria in patients with chronic SCI.…”

Section: Introductionmentioning

confidence: 99%

“…1,2 Given the difficulty with 24-h urine collections, the National Kidney Foundation recommends measuring simple urine dipstick protein (DSP) for those at lower risk for kidney disease, or determining the random urine protein:creatinine ratio (UPC) for those at higher risk. 3 DSP is accurate in predicting clinical proteinuria in the general population, 4 and the use of the UPC to quantify proteinuria is considered accurate for normal individuals, pregnant women, patients with diabetes mellitus, renal transplant recipients, children with nephrotic syndrome [5][6][7][8] and patients with glomerulonephritis and impaired renal function. 9 Proteinuria is recognized as an independent risk factor for cardiovascular disease, 11 renal disease 9 and increased mortality in the general population.…”

Section: Introductionmentioning

confidence: 99%

“…4 Simply, for clinical proteinuria (X0.5 gm per day), all DSP levels were considered positive except for (a) trace proteinuria with a SG 41.015 and (b) 1 þ proteinuria with a SG 41.025.…”

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confidence: 99%

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Determining the optimal method for proteinuria detection in chronic spinal cord injury

et al. 2011

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Study design: A retrospective analysis. Objectives: The objective of this study is to determine whether dipstick protein analysis (DSP) or random urine protein:creatinine ratios (UPC) are accurate in predicting clinical proteinuria in the chronic spinal cord injury (SCI) population. Methods: A retrospective analysis was performed in 219 veterans with SCI, comparing DSP and 24-h urine protein excretion. Sensitivity, specificity, predictive values (PV) and receiver-operator characteristic (ROC) curves of DSP in predicting clinical proteinuria were calculated with and without correction for specific gravity (SG). A prospective study was also performed in 62 SCI patients, comparing the UPC and 24-h urines. Sensitivity, specificity, PV and ROC curves of UPC in predicting clinical proteinuria were calculated. Results: Any level of positive DSP had high specificity, but low sensitivity, for detecting the presence of clinical proteinuria. ROC curves of DSP for identifying clinical proteinuria yielded area under the curve of 0.749 (95% confidence interval 0.699-0.794), and adjustment for SG did not significantly improve accuracy. A UPC of o0.3 was sensitive with a high negative PV for ruling out clinical proteinuria, whereas a ratio 40.8 was specific with a high positive PV. A UPC between 0.3-0.8 had an intermediate sensitivity and specificity. Conclusion: Urine collections of 24-h are still needed in the chronic SCI population for accurate detection of clinically significant proteinuria. DSP may not reliably detect low-grade clinical proteinuria, whereas a UPC below 0.3 may be used to rule out clinical range proteinuria.

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Section: Discussionmentioning

confidence: 67%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…4 Simply, for clinical proteinuria (X0.5 gm per day), all DSP levels were considered positive except for (a) trace proteinuria with a SG 41.015 and (b) 1 þ proteinuria with a SG 41.025.…”

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confidence: 99%

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Determining the optimal method for proteinuria detection in chronic spinal cord injury

et al. 2011

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“…The urine dipstick is also a relatively insensitive marker for initial increases in protein excretion, not generally becoming positive until protein excretion exceeds 300 to 500 mg/day. Limited data suggest that the combination of specific gravity plus dipstick proteinuria may significantly improve the ability to detect proteinuria (Constantiner et al, 2005). The dipstick may also be insufficiently sensitive in multiple myeloma.…”

Section: Markers Of Kidney Damagementioning

confidence: 99%