Article

The objective of this study is to determine whether dipstick protein analysis (DSP) or random urine
protein:creatinine ratios (UPC) are accurate in predicting clinical proteinuria
in the chronic spinal cord injury (SCI) population.
METHODS: A retrospective
analysis was performed in 219 veterans with SCI, comparing DSP and 24-h urine
protein excretion. Sensitivity, specificity, predictive values (PV) and
receiver-operator characteristic (ROC) curves of DSP in predicting clinical
proteinuria were calculated with and without correction for specific gravity
(SG). A prospective study was also performed in 62 SCI patients, comparing the
UPC and 24-h urines. Sensitivity, specificity, PV and ROC curves of UPC in
predicting clinical proteinuria were calculated.
RESULTS: Any level of positive
DSP had high specificity, but low sensitivity, for detecting the presence of
clinical proteinuria. ROC curves of DSP for identifying clinical proteinuria
yielded area under the curve of 0.749 (95% confidence interval 0.699-0.794), and
adjustment for SG did not significantly improve accuracy.
A UPC of <0.3 was
sensitive with a high negative PV for ruling out clinical proteinuria, whereas a
ratio >0.8 was specific with a high positive PV. A UPC between 0.3-0.8 had an
intermediate sensitivity and specificity. CONCLUSION: Urine collections of 24-h
are still needed in the chronic SCI population for accurate detection of
clinically significant proteinuria. DSP may not reliably detect low-grade
clinical proteinuria, whereas a UPC below 0.3 may be used to rule out clinical range proteinuria.

Langue : ANGLAIS