J Med Assoc Thai 2000; 83 (7):797

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The Utility of Conventional Dipsticks for Urinary Protein for Screening of Microalbuminuria in Diabetic Patients
Soonthornpun S Mail, Thammakumpee N , Thamprasit A , Rattarasarn C , Leelawattana R , Setasuban W

NATA WAN THAMMAKUMPEE, B.Sc. *,
CHATCHALIT RATTARASARN, M.D.*,
WORAWONG SETASUBAN, M.D.*
The demonstration that microalbuminuria is predictive of overt diabetic. nl:!phr()pathy has
created a demand for the
routine-~easurement
of urinary albumin in diabetic patients ... We
assessed the sensitivity, specificity, positive and negative predictive values of the conventional
dipsticks for urinary protein (Ames Muliistix, Bayer Diagnostic, Australia) as the s_creening test
for microalbuminuria in diabetic patients compared with
~icral-
Test JI (Boehringer Mannheim,
Germany).
~adioimmunoassay
for albumin was taken as standard for comparison. With the
urinary albumin concentration of 20 mg/L as a discriminating level of microalbuminuria, Micrai-
Test II had a sensitivity of 98.8 per cent and a specificity of 68.6 per cent whereas Ames
Multistix had lower sensitivity but higher specificity.
If
urinary albumin concentration of 60
mg/L was used instead as a discriminating level of microalbuminuria, none of Ames Multistix
by visual reading and only 5 of 32 (15.6%) of those by reflectance photometer had false negative
results. By visual reading, the sensitivity of Ames Multistix was increased from 68.1 to I 00 per
cent with the drop in specificity from 85.7 to 50.2 per cent. On the other hand, the sensitivity was
increased from 37.4 to 84.4 per cent but the specificity was maintained if reflectance photometer
was used. In conclusion, Ames Multistix was less sensitive than Micra!-Test
II
in detection
of urinary albumin concentration above 20 mg/L. At higher urinary albumin concentration above
60 mg/L which indicates a clinically significant microalbuminuria, the sensitivity of Ames
Multistix was increased to 100 per cent. Ames Multistix which is much less expensive than
Micra!-Test
II,
can be used as the screening test for significant microalbuminuria in clinical
practice particularly in cases having financial problems.
Key word : Dipsticks, Microalbuminuria, Urinary Protein, Diabetes Mellitus

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