Use of a first-line urine protein-to-creatinine ratio strip test on random urines to rule out proteinuria in patients with chronic kidney disease

Nephrol Dial Transplant. 2009 Apr;24(4):1189-93. doi: 10.1093/ndt/gfn612. Epub 2008 Nov 5.

Abstract

Background: Urine protein strip tests are often used in the ward or clinic as first-line measures of proteinuria. The ability of a semi-quantitative meter-read strip test for the protein:creatinine ratio, Multistix* PRO 10LS (Siemens Medical Solutions, Tarrytown, USA), was assessed as a first-line test to exclude significant proteinuria in the monitoring of patients with established chronic kidney disease.

Methods: Eighty-six patients attending a hospital renal outpatient clinic collected three random urine samples during a 24-h period. Random urine protein:creatinine ratios measured by the strip test were compared to the laboratory estimation of 24-h protein excretion on that same day.

Results: At significant protein excretion of 0.3 g/24 h, the strips elicited negative predictive values in the range of 91.2-94.1% and negative likelihood ratios of 0.01-0.12, using all the random urines. Receiver-operator characteristic curve analysis also demonstrated good performance with all samples.

Conclusions: The strip test allows the physician to rule out significant proteinuria at the patient consultation on a random urine sample, obviating the need for specially collected samples, and with the added benefit of reducing the need for a lengthy and costly quantitative laboratory follow-up by approximately 40-48%.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Chronic Disease
  • Creatinine / urine
  • Female
  • Humans
  • Kidney Diseases / complications*
  • Male
  • Middle Aged
  • Outpatient Clinics, Hospital
  • Predictive Value of Tests
  • Proteinuria / diagnosis*
  • Proteinuria / etiology
  • Reagent Strips

Substances

  • Reagent Strips
  • Creatinine