Original InvestigationPathogenesis and Treatment of Kidney DiseaseDiagnostic Accuracy of Urine Dipsticks for Detection of Albuminuria in the General Community
Section snippets
Participants
This analysis is based on cross-sectional baseline data from AusDiab (Australian Diabetes, Obesity and Lifestyle Study), a population-based study of Australian adults initially surveyed in 1999-2000. Details of the survey methods have been described.21 A stratified cluster sampling method was used to select a nationally representative sample of the noninstitutionalized Australian population 25 years or older. A total of 20,347 eligible individuals enrolled from 42 randomly selected urban and
Participant Characteristics
Of eligible participants with complete dipstick and laboratory urinalysis data (n = 10,944), 45.3% were men and mean age was 51.6 ± 14.4. Participant characteristics are listed in Table 1. Participants with albuminuria had an older age distribution and higher rates of diabetes, hypertension, previous cardiovascular events, and eGFR <60 mL/min/1.73 m2. Proportions of the cohort with measured ACR ≥30 mg/g or ACR ≥300 mg/g were 6.6% and 0.8%, respectively. Dipstick urinalysis returned a negative,
Discussion
Community-based cohort studies show that dipstick urinalysis predicts long-term risk of end-stage kidney disease and cardiovascular and all-cause mortality.4, 5, 6, 7, 8, 9 However, uncertainty exists about the utility of dipsticks as a screening tool in this setting. We found that in a population-based cohort, a dipstick reading ≥1+ identified individuals with ACR ≥30 mg/g with high specificity and strong negative predictive value. A dipstick reading of trace or higher maintained a similar
Acknowledgements
Support: Dr White is supported by a Capacity Building Grant from the Australian Government National Health and Medical Research Council. The AusDiab Kidney Study is a substudy of the AusDiab Study. In addition to support from the AusDiab co-coordinating team, led by Prof Paul Zimmet and A/Prof Jonathan Shaw at the Baker IDI Heart and Diabetes Institute, Melbourne, Australia, their sponsors, and the National Health and Medical Research Council of Australia (NHMRC grant 233200), the AusDiab
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Originally published online March 16, 2011.