VALIDATION OF URINE DIPSTICK CONVERSION FORMULA TO ALBUMIN CREATININE RATIO IN DETERMINING ALBUMINURIA IN CHRONIC KIDNEY DISEASE PATIENTS AT FATIMA UNIVERSITY MEDICAL CENTER: A CROSS-SECTIONAL STUDY

8 Feb 2025 12 a.m. 12 a.m.
WCN25-AB-532, Poster Board= SAT-125

Introduction:

Albuminuria is a marker of kidney damage. Spot albumin-to-creatinine ratio (ACR) is commonly used as an index of albuminuria, but in resource-limited settings, clinicians often rely on the inexpensive, convenient urinary dipstick to assess proteinuria. This current study evaluated the predictive accuracy of a urine dipstick protein conversion formula to ACR for albuminuria among Filipino Chronic Kidney Disease (CKD) patients seen at the Fatima University Medical Center in Valenzuela and Antipolo.

Methods:

Sumida formula conversion of urine dipstick to predicted UACR

This two-center cross-sectional study included a total of 120 CKD patients across all stages with same day measures of ACR and dipstick protein. The study utilized the empirically developed equation for the conversion of dipstick protein to ACR by Sumida et al. (2020), which was compared to spot urine ACR, to determine its concordance and diagnostic accuracy. 

 

Results:

Table 1. Demographic and Baseline Characteristics of the Study Population

Table 2. Comparison of predicted ACR from urine dipstick and urinary ACR across CKD stages

Table 4. Diagnostic Performance of predictive ACR from urine dipstick for severely increased urine protein levels

Results of the study showed that there was no significant difference between the means of the predicted ACR from urine dipstick and spot urine ACR among patients with stage 1 (27.40±18.26 vs 45.61±37.83; p=0.06), stage 2 (82.30±167.53 vs 269.27±604.19; p=0.190), stage 3A (325.95±450.21 vs 563.75±713.17; p=0.215), stage 3B (203.05±298.39 vs 433.34±813.68; p=0.242), stage 4 (641.85±589.33 vs 1122.93±186.93; p=0.275), and stage 5 (699.54±541.01 vs 3162.98±1991.39; p=0.071). The concordance rates of the two tests were as follows: 60% for stage 1, 80% for stage 2, 60% for stage 3A, 75% for stage 3B, 85% for stage 4, and 60% for stage 5 with a 74.17% overall concordance rate. Finally, urine dipstick conversion formula to ACR has a diagnostic accuracy of 90.00% (95% CI: 83.18% - 94.73%), sensitivity of 85.11% (95% CI: 71.69% - 93.80%), specificity of 93.15% (95% CI: 84.74% - 97.74%), positive predictive value of 88.89% (95% CI: 77.29% - 94.95%), negative predictive value of 90.67% (95% CI: 83.02% - 95.07%), positive likelihood ratio of 12.43 (95% CI: 5.29 to 29.20), and negative likelihood ratio of 0.16 (95% CI: 0.08 to 0.32).

Conclusions:

The urine dipstick conversion formula by Sumida et al. for urine ACR can be used as a surrogate for spot urine ACR in providing cost-effective and real-time rapid assessment of albuminuria in CKD patients and can be highly useful in resource-limited settings.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.