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首页> 外文期刊>The Journal of rheumatology >Diagnostic accuracy study of urine dipstick in relation to 24-hour measurement as a screening tool for proteinuria in lupus nephritis.
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Diagnostic accuracy study of urine dipstick in relation to 24-hour measurement as a screening tool for proteinuria in lupus nephritis.

机译：尿液量油尺与24小时测量有关的诊断准确性研究，作为狼疮性肾炎蛋白尿的筛查工具。

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OBJECTIVE: Early detection of renal involvement in lupus prevents poor outcomes. Although published guidelines recommend urine dipstick as an appropriate screening test and evidence suggests a majority of American rheumatologists use dipstick to screen for proteinuria, the performance of this diagnostic approach in lupus has not been reported. We examined the validity of qualitative urine dipstick versus quantitative 24-hour measurement to accurately detect proteinuria, including low-level proteinuria. METHODS: We performed a diagnostic accuracy study using paired samples from the Johns Hopkins University School of Medicine and the Ohio State University School of Medicine lupus cohorts. All qualitative urine dipstick values were obtained within 1 day of a 24-hour urine collection. RESULTS: We analyzed the performance of 3 urine dipstick assays to detect proteinuria compared to 24-hour protein/creatinine ratios, using 2224 dipstick measures from 296 patients. The sensitivity of a > or = 1+ dipstick result to detect quantitative proteinuria (> or = 0.50 g protein/g creatinine) was 82.7% for the Clinitek, 97.7% for the Atlas, and 85.5% for the Bayer assay. The corresponding sensitivity to detect low-level proteinuria, (0.50-0.99 g protein/g creatinine) was 63.1%, 96.4%, and 80.7%, respectively. The specificity to correctly exclude proteinuria (< 0.50 g protein/g creatinine) with negative/trace results was 86.1%, 62.2%, and 59.4%. There was considerable variability in the range of protein/creatinine ratios detected at each dipstick level of proteinuria. CONCLUSION: Urine dipsticks demonstrate substantial variability and often poor validity to accurately detect proteinuria at quantitative levels; this warrants further diagnostic evaluation. Clinicians should consider quantified proteinuria assays as a more accurate screening tool in the diagnostic evaluation of lupus nephritis.
机译：目的：及早发现狼疮中的肾脏受累可预防不良预后。尽管已发布的指南建议使用尿液尺作为适当的筛查测试，并且证据表明大多数美国风湿病学家使用尿液尺来筛查蛋白尿，但尚未报道这种诊断方法在狼疮中的作用。我们检查了定性尿液试纸与定量24小时测量法的准确性，以准确检测蛋白尿，包括低水平蛋白尿。方法：我们使用约翰霍普金斯大学医学院和俄亥俄州立大学医学院狼疮队列的配对样本进行了诊断准确性研究。在24小时尿液收集的1天内获得所有定性尿液量尺值。结果：我们分析了296种患者的2224种试纸条测量方法，比较了24种蛋白质/肌酐比率与3种尿液试纸条检测方法的性能。 >或= 1+量油尺结果检测定量蛋白尿（>或= 0.50 g蛋白/ g肌酸酐）的敏感性，Clinitek为82.7％，Atlas为97.7％，Bayer分析为85.5％。检测低水平蛋白尿（0.50-0.99 g蛋白/ g肌酐）的相应灵敏度分别为63.1％，96.4％和80.7％。正确排除蛋白尿（<0.50 g蛋白/ g肌酐）的阴性/痕迹结果特异性为86.1％，62.2％和59.4％。在每个试纸尺水平的蛋白尿中检测到的蛋白/肌酐比率范围存在很大差异。结论：尿液试纸显示出很大的变异性，并且经常不能正确地定量检测蛋白尿。这值得进一步的诊断评估。临床医生应考虑将定量蛋白尿测定法作为诊断狼疮肾炎的更准确的筛查工具。

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