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Side‐room Tests to Screen for Micro‐albuminuria in Diabetes Mellitus
Author(s) -
Watts G. F.,
Hodgson B.,
Morris R. W.,
Shaw K. M.,
Polak A.
Publication year - 1988
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.1988.tb00992.x
Subject(s) - medicine , microalbuminuria , concordance , predictive value , diabetes mellitus , urine , albuminuria , morning , surgery , gastroenterology , endocrinology
Three side‐room tests (latex bead immunoagglutination test, LBT; 25% sulphosalicylic acid test, SST; microalbutest, MAT) for the detection of microalbuminuria in diabetics are described and their screening potential and practicability assessed. One hundred insulin‐dependent diabetics attending a diabetic clinic provided an early morning urine sample (Albustix‐negative) which was subjected to each of the three tests, and urinary albumin concentration (U A ) was assayed by RIA. Tests were assessed in random order by two trained operators using a semiquantitative grading scale with 100% concordance between 10 observers. All test results trace +ve were sufficiently sensitive (sensitivity 90%) in detecting U A >15mg/l, but MAT exhibited a significantly reduced specificity (69%) and positive predictive value (58%). For a reference U A >30mg/l, LBT and SST results trace +ve and MAT results +ve showed a sensitivity of 100%, a specificity > 85% and a positive predictive value >60%. Reagent shelf‐life was shortest with LBT. SST involved centrifugation or filtration. Technical skill required was highest with LBT and lowest with MAT. Costs were slightly higher with LBT than SST and were not available for MAT.