Can an algorithm based on dipstick urine protein and urine specific gravity accurately predict proteinuria?

Hans L Hillege

This article has no abstract so we have provided the first paragraph of the full text.

Increasing evidence indicates that proteinuria is the most powerful predictor of progression from glomerular disease to chronic renal failure. Furthermore, accumulating data show that proteinuria has harmful secondary effects on the kidney, irrespective of cause. A strong association between the magnitude of proteinuria and the rate of renal function decline has been reported in glomerular disorders including focal segmental glomerulosclerosis, diabetic nephropathy and systemic lupus erythematosus. Total urine protein excretion reflects a combination of glomerular permeability, tubular leakage, tubular secretion, and normal urinary protein excretion by the kidneys; by contrast, urine albumin excretion primarily reflects glomerular permeability. The American Diabetes Association and the US National Kidney Foundation currently recommend measurement of proteinuria in a timed (e.g. 24-h) urine specimen to detect chronic kidney disease; however, collection of such samples can be very difficult. The US National Kidney Foundation K/DOQI guidelines advocate use of standard or albumin-specific dipsticks, or calculation of protein : creatinine or albumin : creatinine ratio, to assess proteinuria. Although dipstick screening for proteinuria or albuminuria is often a satisfactory means of detecting kidney disease, clinicians should be aware of the possibility of false-positive and, more importantly, false-negative results.

ARTICLE NAVIGATION - ARTICLE TOOLS

• Full text
• Download PDF
• Send to a friend
• PDA services
• Permissions

ISSUE NAVIGATION - THIS ISSUE

• Table of Contents
• Previous article
• Next article