ABSTRACT
Background: Microalbuminuria; the presence of low levels of albumin in the urine; indicates renal damage and is recognised as a risk factor for the progression of renal and cardiovascular disease. Several international scientific bodies recommend microalbuminuria screening. Point-of-care testing (POCT) of microalbuminuria allows immediate identification of risk; and monitoring of treatment effects. In this study; two POCT instruments were evaluated as microalbuminuria screening methods. Method: Spot urine specimens from diabetic patients were analysed with the quantitative HemoCuer urine albumin analyser (n = 245); and the semiquantitative Clinitekr microalbumin urine dipstick (n = 204). These results were compared to the respective data for laboratory-determined albumin (nephelometry); creatinine (modified Jaffe) and albumin-to-creatinine ratio (ACR). Results: Linear regression analysis demonstrated a good correlation for the HemoCuer urine albumin with the laboratorydetermined albumin concentration (y = 0.8557x + 0.2487y; r = 0.97). The sensitivities for the HemoCuer and Clinitekr POCTsystems were 79.6and 83.8; and the pecificities 97.1and 93.8respectively. Positive and negative predictive values for the HemoCuer were 95.6and 85.8; and were 88.6and 91.0the Clinitekr. The repeatability of both instruments was excellent. Both instruments are easy to use; and more cost-effective than the laboratory methods for albumin and ACR. Conclusion: Both the HemoCuer and the Clinitekr microalbumin POCT systems for albuminuria are easy to use and inexpensive; and are adequately accurate as a screening method. Although the HemoCuer POCT system measures only urine albumin concentration; its sensitivity and specificity compared well with that of the Clinitekr POCT system; which determines the ACR