Tomoko Usui1, Yui Yoshida2,3, Hiroshi Nishi2, Shintaro Yanagimoto4, Yutaka Matsuyama3, Masaomi Nangaku2. 1. Division of Nephrology and Endocrinology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. tusui-tky@umin.ac.jp. 2. Division of Nephrology and Endocrinology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. 3. Department of Biostatistics, The University of Tokyo, Tokyo, Japan. 4. Division for Health Service Promotion, The University of Tokyo, Tokyo, Japan.
Abstract
BACKGROUND: Urine dipstick tests are often used to evaluate proteinuria during health checkups. We examined the dipstick's accuracy in assessing the proteinuria levels among Japanese workers. METHODS: We assessed subjects aged ≥ 18 years who had a health checkup at the University of Tokyo in 2016 or 2017 (n = 5383). Proteinuria was stratified by urine protein-to-creatinine ratio (PCR): A1, < 150 mg/gCre; A2, 150-499 mg/gCre; and A3, ≥ 500 mg/gCre. The accuracy of a dipstick result of ± or higher to detect a PCR level of ≥ A2 was examined. We compared changes in dipstick results and PCR level in 136 subjects evaluated twice with a median interval of 119 days. RESULTS: The subjects' mean age was 40 years, and half were women. The dipstick results were - in 94.9%, ± in 4.1%, and ≥ 1 + in 1.0%. The PCR level was A1, A2, A3 in 98.6%, 1.2%, and 0.2% of the subjects, respectively. The sensitivity, specificity, and positive and negative predictive values of a ± or higher dipstick result to detect A2 or higher were 66.2%, 95.6%, 17.5%, and 99.5%, respectively. Among the 136 subjects examined twice, 134 (98.5%) had no change in PCR level (A1 in all cases) despite a decrease or increase in dipstick results. CONCLUSION: Urine dipstick results of ± or above had a high specificity but low sensitivity and positive predictive value to detect PCR proteinuria of A2 or higher. Confirmation by quantitative protein measurement should be recommended for individuals at high risk of chronic kidney disease.
BACKGROUND: Urine dipstick tests are often used to evaluate proteinuria during health checkups. We examined the dipstick's accuracy in assessing the proteinuria levels among Japanese workers. METHODS: We assessed subjects aged ≥ 18 years who had a health checkup at the University of Tokyo in 2016 or 2017 (n = 5383). Proteinuria was stratified by urine protein-to-creatinine ratio (PCR): A1, < 150 mg/gCre; A2, 150-499 mg/gCre; and A3, ≥ 500 mg/gCre. The accuracy of a dipstick result of ± or higher to detect a PCR level of ≥ A2 was examined. We compared changes in dipstick results and PCR level in 136 subjects evaluated twice with a median interval of 119 days. RESULTS: The subjects' mean age was 40 years, and half were women. The dipstick results were - in 94.9%, ± in 4.1%, and ≥ 1 + in 1.0%. The PCR level was A1, A2, A3 in 98.6%, 1.2%, and 0.2% of the subjects, respectively. The sensitivity, specificity, and positive and negative predictive values of a ± or higher dipstick result to detect A2 or higher were 66.2%, 95.6%, 17.5%, and 99.5%, respectively. Among the 136 subjects examined twice, 134 (98.5%) had no change in PCR level (A1 in all cases) despite a decrease or increase in dipstick results. CONCLUSION: Urine dipstick results of ± or above had a high specificity but low sensitivity and positive predictive value to detect PCR proteinuria of A2 or higher. Confirmation by quantitative protein measurement should be recommended for individuals at high risk of chronic kidney disease.
Authors: Ron T Gansevoort; Kunihiro Matsushita; Marije van der Velde; Brad C Astor; Mark Woodward; Andrew S Levey; Paul E de Jong; Josef Coresh Journal: Kidney Int Date: 2011-02-02 Impact factor: 10.612
Authors: Josef Coresh; Hiddo J L Heerspink; Yingying Sang; Kunihiro Matsushita; Johan Arnlov; Brad C Astor; Corri Black; Nigel J Brunskill; Juan-Jesus Carrero; Harold I Feldman; Caroline S Fox; Lesley A Inker; Areef Ishani; Sadayoshi Ito; Simerjot Jassal; Tsuneo Konta; Kevan Polkinghorne; Solfrid Romundstad; Marit D Solbu; Nikita Stempniewicz; Benedicte Stengel; Marcello Tonelli; Mitsumasa Umesawa; Sushrut S Waikar; Chi-Pang Wen; Jack F M Wetzels; Mark Woodward; Morgan E Grams; Csaba P Kovesdy; Andrew S Levey; Ron T Gansevoort Journal: Lancet Diabetes Endocrinol Date: 2019-01-08 Impact factor: 32.069
Authors: Brad C Astor; Kunihiro Matsushita; Ron T Gansevoort; Marije van der Velde; Mark Woodward; Andrew S Levey; Paul E de Jong; Josef Coresh; Brad C Astor; Kunihiro Matsushita; Ron T Gansevoort; Marije van der Velde; Mark Woodward; Andrew S Levey; Paul E de Jong; Josef Coresh; Meguid El-Nahas; Kai-Uwe Eckardt; Bertram L Kasiske; Jackson Wright; Larry Appel; Tom Greene; Adeera Levin; Ognjenka Djurdjev; David C Wheeler; Martin J Landray; John N Townend; Jonathan Emberson; Laura E Clark; Alison Macleod; Angharad Marks; Tariq Ali; Nicholas Fluck; Gordon Prescott; David H Smith; Jessica R Weinstein; Eric S Johnson; Micah L Thorp; Jack F Wetzels; P J Blankestijn; A D van Zuilen; Vandana Menon; Mark Sarnak; Gerald Beck; Florian Kronenberg; Barbara Kollerits; Marc Froissart; Benedicte Stengel; Marie Metzger; Giuseppe Remuzzi; Piero Ruggenenti; Annalisa Perna; H J Lambers Heerspink; Barry Brenner; Dick de Zeeuw; Peter Rossing; Hans-Henrik Parving; Priscilla Auguste; Kasper Veldhuis; Yaping Wang; Laura Camarata; Beverly Thomas; Tom Manley Journal: Kidney Int Date: 2011-02-02 Impact factor: 10.612