ABSTRACT
We aimed to develop a reliable, low cost method to assess the early stages of renal impairment in diabetes, for use in high-risk populations in countries with limited resources. We evaluated a trichloroacetic acid (TCA) turbidimetric method for microproteinuria screening in patients with diabetes. The method was compared with an immunoturbidimetric procedure for the detection of microalbumuniuria. Both methods performed within limits of allowable uncertainty based on inter- and intra-individual variation. A urinary albumin/creatinine ratio of 3.0 g/mol, assumed as diagnostic of microalbuminuria, was found to correlate with a cut-off value of 24 mg/L for microproteinuria. The clinical sensitivity and specificity of the TCA method determined against this ratio were 86% and 90% respectively. The reliability and practicability of the TCA method renders it suitable for the detection of early stage renal damage, with emphasis on screening high-risk populations in countries with limited resources.
Subject(s)
Albuminuria/diagnosis , Albuminuria/urine , Mass Screening/methods , Nephelometry and Turbidimetry/methods , Proteinuria/diagnosis , Proteinuria/urine , Albuminuria/epidemiology , Albuminuria/etiology , Cost-Benefit Analysis , Creatinine/urine , Developing Countries , Diabetes Mellitus, Type 2/complications , Discriminant Analysis , Early Diagnosis , Female , Humans , Immunoassay/economics , Immunoassay/methods , Immunoassay/standards , Kidney Failure, Chronic/etiology , Male , Mass Screening/economics , Mass Screening/standards , Nephelometry and Turbidimetry/economics , Nephelometry and Turbidimetry/standards , Observer Variation , Predictive Value of Tests , Prevalence , Proteinuria/epidemiology , Proteinuria/etiology , ROC Curve , Risk Factors , Sensitivity and Specificity , Specimen Handling/methods , Trichloroacetic AcidABSTRACT
We aimed to develop a reliable, low cost method to assess the early stages of renal impairment in diabetes, for use in high-risk populations in countries with limited resources. We evaluated a trichloroacetic acid [TCA] turbidimetric method for microproteinuria screening in patients with diabetes. The method was compared with an immunoturbidimetric procedure for the detection of microalbumuniuria. Both methods performed within limits of allowable uncertainty based on inter- and intra-individual variation. A urinary albumin/creatinine ratio of 3.0 g/mol, assumed as diagnostic of microalbuminuria, was found to correlate with a cut-off value of 24 mg/L for microproteinuria. The clinical sensitivity and specificity of the TCA method determined against this ratio were 86% and 90% respectively. The reliability and practicability of the TCA method renders it suitable for the detection of early stage renal damage, with emphasis on screening high-risk populations in countries with limited resources
