Journal ArticleDOI
Screening school children for albuminuria, proteinuria and occult blood with dipsticks.
Michael J. Pugia,John A. Lott,Junko Kajima,Takaaki Saambe,Miyuki Sasaki,Kooichi Kuromoto,Reiko Nakamura,Hisae Fusegawa,Yoshihide Ohta +8 more
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TLDR
The many reports on the association of albuminuria and risk of renal disease recommend that screening should be done for albumin rather than protein, and the cut-off for the albumin dipsticks probably should be set somewhat lower to reduce the number of false negatives and increase the sensitivity of the dipstick.Abstract:
Beginning in 1974, the Japanese Ministry of Health Welfare directed the screening of schoolchildren for proteinuria. We studied their procedure and methods in 6197 school children and also evaluated a new urine dipstick that measures albumin concentrations down to about 10 mg/l and creatinine down to about 300 mg/l. We used specimens from adult in- and outpatients to test the accuracy of the dipsticks. Based on the quantitative results, we set as cutoffs or = "150" mg/l or an albumin of I "30" mg/l indicated increased risk of developing or having a genitourinary disorder. The sensitivity/specificity of the protein dipstick was 95.1%/95.5%, and the same for the albumin dipstick was 83.8%/93.8%. The cut-off for the albumin dipsticks probably should be set somewhat lower to reduce the number of false negatives and increase the sensitivity of the dipstick. When we compared the quantitative albumin to the protein dipsticks with the above cut-offs, we found the sensitivity/specificity to be 79.3%/94.4%, i.e., much like the albumin dipstick results. The many reports on the association of albuminuria and risk of renal disease recommend that screening should be done for albumin rather than protein. Based on the data from the school children, we estimate that a dipstick albumin of "30" mg/l is borderline increased risk, and that a protein dipstick of "150" mg/l is the same. If we call the dipstick "10" mg/l albumin, "30" mg/l albumin and the "150" mg/l protein results "low risk," then we estimate the prevalence of albuminuria in the school children to be about 2.1% and proteinuria to be about 4.3%. Children with these values should have a quantitative test for albumin and protein. We also tested a dipstick for creatinine and found increasing values with increasing age in both genders; the older boys had significantly higher creatinine values than the older girls and younger boys. For the albumin/creatinine ratio, we found 6028 children with a ratio of or = 30 mg/g indicating increased risk. The ratio may be more useful owing to the likely reduction of the number of false negatives and false positives.read more
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K/DOQI clinical practice guidelines for chronic kidney disease: Evaluation, classification, and stratification
Andrew S. Levey,Josef Coresh,Kline Bolton,Bruce Culleton,Kathy Schiro Harvey,T. Alp Ikizler,Cynda Ann Johnson,Annamaria T. Kausz,Paul L. Kimmel,John W. Kusek,Adeera Levin,Kenneth L. Minaker,Robert Nelson,Helmut G. Rennke,Michael Steffes,Beth Witten,Ronald J. Hogg,Susan Furth,Kevin V. Lemley,Ronald J. Portman,George Schwartz,Joseph Lau,Ethan M Balk,Ronald D. Perrone,Tauqeer Karim,Lara Rayan,Inas Al-Massry,Priscilla Chew,Brad C. Astor,Deirdre De Vine,Garabed Eknoyan,Nathan W. Levin,Sally Burrows-Hudson,William F. Keane,Alan S. Kliger,Derrick Latos,Donna Mapes,Edith Oberley,Kerry Willis,George R. Bailie,Gavin J. Becker,Jerrilynn Burrowes,David Churchill,Allan J. Collins,William Couser,Dick DeZeeuw,Alan Garber,Thomas Golper,Frank A. Gotch,Antonio M. Gotto,Joel W. Greer,Richard H. Grimm,Ramon G. Hannah,Jaime Herrera Acosta,Ronald J. Hogg,Lawrence G. Hunsicker,Michael J. Klag,Saulo Klahr,Caya Lewis,Edmund G. Lowrie,Arthur J. Matas,Sally McCulloch,Maureen Michael,Joseph V. Nally,John M. Newmann,Allen R. Nissenson,Keith Norris,William F. Owen,Thakor G. Patel,Glenda Payne,Rosa A. Rivera-Mizzoni,David A. Smith,Robert A. Star,Theodore Steinman,Fernando Valderrábano,John Walls,Jean Pierre Wauters,Nanette Wenger,Josephine P. Briggs +78 more
TL;DR: In the early 1990s, the National Kidney Foundation (K/DOQI) developed a set of clinical practice guidelines to define chronic kidney disease and to classify stages in the progression of kidney disease.
Journal ArticleDOI
3–5 year longitudinal follow-up of pediatric patients after acute renal failure
David J. Askenazi,Daniel I. Feig,N.M. Graham,S. Hui-Stickle,Stuart L. Goldstein,Stuart L. Goldstein +5 more
TL;DR: Patients have high risks of ongoing residual renal injury and death after ARF; therefore, periodic evaluation after the initial insult is necessary.
Journal ArticleDOI
European Urinalysis Guidelines
TL;DR: Urinalysis should always be performed on the basis of medical need, and appropriate examinations for various clinical populations and presentations should be determined by cost/ bene®t analysis.
Journal ArticleDOI
Urinary protein and albumin excretion corrected by creatinine and specific gravity
TL;DR: A dipstick test plus an optical strip reader that can measure urine protein, albumin, and creatinine and calculate the appropriate ratios provides a better screening test for albuminuria or proteinuria than one measuring only albumin or protein.
Journal ArticleDOI
Being overweight modifies the association between cardiovascular risk factors and microalbuminuria in adolescents.
TL;DR: The prognostic importance of microalbuminuria in overweight and nonoverweight adolescents with regard to future cardiovascular and renal disease needs to be defined in prospective studies conducted specifically in children.
References
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Journal ArticleDOI
The Stages in Diabetic Renal Disease: With Emphasis on the Stage of Incipient Diabetic Nephropathy
TL;DR: A series of stages in the development of renal changes in diabetes, characterized by early hyperfunction and hypertrophy, are defined, which may be useful both in clinical work and in research activities.
Journal ArticleDOI
Use of Single Voided Urine Samples to Estimate Quantitative Proteinuria
TL;DR: It is concluded that the determination of the protein/creatinine ratio in single urine samples obtained during normal daylight activity, when properly interpreted by taking into consideration the effect of different rates of creatinine excretion, can replace the 24-hour urine collection in the clinical quantitation of proteinuria.
Journal ArticleDOI
Diurnal Variations of Blood Pressure and Microalbuminuria in Essential Hypertension
TL;DR: The increased amount of UAE in nondipper hypertensive patients suggests the presence of greater renal damage than in dippers, and whether levels of urinary albumin excretion correlate with average diurnal, nocturnal, or 24-h blood pressure better than with office blood pressure.
Journal ArticleDOI
Microalbuminuria. Implications for micro- and macrovascular disease.
Torsten Deckert,Allan Kofoed-Enevoldsen,Kirsten Nørgaard,Knut Borch-Johnsen,Bo Feldt-Rasmussen,Tonny Jensen +5 more
TL;DR: Evidence suggests a common pathogenetic mechanism for microalbuminuria and premature atherosclerosis, which affects the composition and structure of the extracellular matrix in many ways and leads to decreased density and sulfation of HS-PG by several mechanisms.
Journal ArticleDOI
Protein creatinine index and Albustix in assessment of proteinuria
TL;DR: It is proposed that the protein creatinine index on random urine samples should be used to supplement dipsticks in screening for proteinuria in cases where misclassification would be serious.