Lambers Heerspink HJ et al. (2008) Screening and monitoring for albuminuria: the performance of the HemoCue point-of-care system. Kidney Int [doi:10.1038/ki.2008.186]

Although a number of desktop systems allow clinicians to measure urinary albumin excretion directly at the point of care, it is not clear whether these devices are as precise and accurate as central laboratory measurements. To evaluate the performance of one such system—the HemoCue Albumin 201 Analyzer, HemoCue, Ängelholm, Sweden—in a cohort of patients, Lambers Heerspink et al. compared the results with those obtained by nephelometry at a central laboratory.

Among the 259 first morning void samples obtained, nephelometry indicated that 151 had albumin concentrations within the measuring range of the HemoCue system; these samples were used for analysis. The coefficient of variation of 10 consecutive HemoCue measurements was in the range 4.9–8.0%, meeting the FDA precision criterion for introduction of a new laboratory method. In total, 94% of the HemoCue measurements differed from the nephelometer measurements by ≤10 mg/l or ≤30%, just under the FDA accuracy cut-off of 95%. Analysis of receiver operating characteristic curves revealed that the sensitivity of the two types of test for predicting albuminuria of ≥30 mg in a subsequent 24 h urine collection on the basis of the albumin concentration of a first morning void were identical at the clinically used cut-off value of 20 mg/l. Among individuals with albuminuria (24 h urinary albumin excretion ≥30 mg/24 h), the median intra-individual coefficients of variation of urinary albumin concentration measured by the two tests were similar.

The authors conclude that the HemoCue system is a valid alternative to central laboratory analysis for the identification and monitoring of patients with microalbuminuria.