Comparison of Proteinuria Determination by Urine Dipstick, Spot Urine Protein Creatinine Index, and Urine Protein 24 Hours in Lupus Patients
Comparison of Proteinuria Determination by Urine Dipstick, Spot Urine Protein Creatinine Index, and Urine Protein 24 Hours in Lupus Patients
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DOI：
10.1097/rhu.0b013e318214bd18
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发表时间：
2011-04-01
影响因子：
3.4
通讯作者：
Louthrenoo, Worawit
中科院分区：
文献类型：
--
作者：
Chotayaporn, Thanyaluk;Kasitanon, Nuntana;Louthrenoo, Worawit
背景资料：一种简单、方便、准确的检测狼疮性肾炎尿蛋白排泄的方法是至关重要的。目的：本研究的目的是确定定性尿试纸测试值的灵敏度和特异性，以检测狼疮患者中0.50 g或更多的定量24小时尿蛋白（24-hUP），评价试纸法检测结果与24-hUP值的总体一致性，并检测点尿蛋白肌酐指数（S-UPCI）与24-hUP的UPCI之间的相关性。方法：对92例狼疮患者进行了前瞻性研究。在24-hUP采集的6小时内获得5种试纸测定（Bayer、Roche、Meditest USA、Standard Diagnostics和Arkray）和S-UPCI的所有试纸检测值。结果：尿试纸法检测0.50 g以上24-hUP的灵敏度为56%~ 80%，特异性为67%~ 92%，尿试纸法检测0.50 g以上24-hUP的灵敏度为56%~ 80%，特异性为67%~ 92%。尿试纸测试值和24-hUP的量值的一致性是一般的（kappa = 0.23-0.32）。S-UPCI与24-hUP的相关系数为0.83（P < 0.0001），24-hUPCI与24-hUP的相关系数为1（P < 0.0001）。24-hUP ≤ 2g/d时，S-UPCI与24-hUP差值的偏倚± 1.96SD为0.23（SD，0.96）g。结论：A ≥ 2+试纸检测尿蛋白相对敏感，但与定量24-hUP相关性较差。S-UPCI和24-hUP可互换用于蛋白尿小于2 g/d的狼疮性肾炎患者的随访。
Background: A simple, convenient, and accurate method for detecting urine protein excretion in lupus nephritis is crucial.Objectives: The objectives of the study were to determine the sensitivity and the specificity of the qualitative urine dipstick test value to detect 0.50 g or greater of the quantitative 24-hour urine protein (24-hUP) in lupus patients, to evaluate an overall agreement of the dipstick test results and the magnitude of 24-hUP, and to examine the correlation between the spot urine protein creatinine index (S-UPCI) and the 24-hour UPCI with that of the 24-hUP.Methods: A prospective study was conducted in 92 patients with lupus. All dipstick test values from 5 dipstick assays (Bayer, Roche, Meditest USA, Standard Diagnostics, and Arkray) and the S-UPCI were obtained within 6 hours of the 24-hUP collection. Of 149 urine samples, only 39% were collected properly and were used for analysis.Results: The sensitivity and specificity of a >= 2+ dipstick test result to detect 0.50 g or greater 24-hUP were 56-% to 80% and 67% to 92%, respectively. The agreement of the urine dipstick test values and the magnitude of 24-hUP was fair (kappa = 0.23-0.32). The correlation between the S-UPCI and the 24-hUP was 0.83 (P < 0.0001), and that of the 24-hour UPCI and the 24-hUP was 1 (P < 0.0001). Using 24-hUP 2 g/d or less, the bias +/- 1.96 SD of the difference of S-UPCI and 24-hUP was 0.23 (SD, 0.96) g.Conclusions: A >= 2+ dipstick test is relatively sensitive to detect significant proteinuria, but it is poorly correlated with quantitative 24-hUP. The S-UPCI and the 24-hUP can be used interchangeably for follow-up in lupus nephritis patients with proteinuria of less than 2 g/d.