The validity of random urine specimen albumin measurement as a screening test for diabetic nephropathy

Abstract

To assess the validity of urine albumin concentration (UAC) and the urine albumin:creatine ratio (UACR) in a random urine specimen (RUS) for screening diabetic nephropathy in Korea, a total of 105 ambulatory diabetes mellitus patients (male:female, 52:53), ages 40-75 years (median 59 years) collected 105 RUSs after completing a timed 24 hour urine collection. Albumin was measured by immunonephelometry. According to the timed urinary albumin excretion rate (UAER) measured in the 24 hour collection (criterion standard), samples were classified normoalbuminuric (UAER < 20 micrograms/min; n = 50), microalbuminuric (UAER 20-200 micrograms/min; n = 30), and macroalbuminuric (UAER > 200 micrograms/min; n = 25). The receiver operating characteristics (ROC) curve of UAC and UACR in a RUS for screening of microalbuminuria (normo- and microalbuminuric samples; n = 80) and macroalbuminuria (micro- and macroalbuminuric samples; n = 55) were plotted. Pearson's coefficients of correlation of 24 hour UAER vs. UAC and UACR were 0.81 and 0.75, respectively (P < 0.001). The point of intersection with a 100%-to-100% diagonal for microalbuminuria were as follows: 31.0 mg/l for UAC and 32.5 mg/g for UACR; for macroalbuminuria 181 mg/l for UAC and 287.3 mg/g for UACR. The sensitivity and specificity of the cut-off points for microalbuminuria were 77% and 82% for UAC and 77% and 92% for UACR. The sensitivity and specificity of the cut-off points for macroalbuminuria were 84% and 90% for UAC and 88% and 90% for UACR. In present study, no difference was observed when comparing the performance of UAC and UACR based on a statistical comparison by McNemar test. The repeated measurements of UAC and UACR in the same individual were statistically similar and were correlated with each other. Based on these results, albumin measurements (UAC and UACR) in a RUS were considered as a valid test for screening diabetic nephropathy.

A Comparative Study of Clinical Utility of Spot Urine Samples with 24-h Urine Albumin Excretion for Screening of Microalbuminuria in Type 2 Diabetic Patients

“…Our vales are comparable with other studies [21,22,33]. According to Ahn et al, UAC had better correlation than ACR in random urine sample (RUS) when compared with 24-h albumin excretion rate [21].…”

“…There are many studies which compared either FMV or RUS and albuminuria measure such as UAC and/or ACR as alternative to measurement of 24-h UAE [21][22][23][24][25][26][27]. Few studies correlated ACR in either single FMV or RUS [17,28,29].…”

Antidiabetic Effects ofCorni FructusExtract in Streptozotocin-Induced Diabetic Rats

“…Urinary albumin excretion has been shown to be a good clinical predictor of renal lesions in diabetic nephropathy 23,24. The increase in urinary albumin excretion, one of the most marked renal pathological findings in diabetic nephropathy results from mesangial expansion, due to pathological accumulation of extra-cellular matrix components 25.…”

Risk factors and prevalence of diabetic peripheral neuropathy: A study of type 2 diabetic outpatients in Bangladesh

“…The urine creatinine level was measured by the Alkaline Picrate (Hitachi 704 Japan) method in the biochemical laboratory, and urine albumin by the Nephelometry (Bn-2 Nephelometer) method in the immunology laboratory. [1314] The detection limit for albumin was 11.6 mg/l. The urinary albumin-to-creatinine ratio (UACR) was calculated.…”