Screening with dipsticks in only useful if one wants to exclude patients
with massive albuminuria. If you want to reduce the massive number of
requests for microalbuminuria, you have to eliminate those patients with
normoalbuminuria. Recently we did a study, yet unpublished, with the DCL's
Immunodip strip for the semiquantitative determination of urinary albumin
(distributed in the Netherlands by Menarini). This strip had a sensitivity
of 98% and a specificity of 89%. According to the guideliness publisched by
Sacks et al. (Clin Chem 2002;48:436-472), a procedure with a sensitivity of
>95% should be used for an efficient screening procedure. Therefore, this
strip could be useful in the efficient elimination of the urines with a
normal albumin excretion. However, a limited amount of false negatives (2%)
will be encountered. If positive results of this strip will be followed by a
quantitative analysis, the false positive rate of 11% does not seem to be
any problem.
A poster with the results of our investigation is included.
In my opinion, this strip also reliably can be used by the GP.
Furthermore, we also have been testing the Hemocue device, but these results
did not meet the "Sacks" criterion inour hands.
With respect to the way of reporting the results, we do report the
albumin-creatinin ratio as well as the albumin and creatinin concentrations
in the first morning urine.
<<Poster DCL microalbumine2.ppt>>
Andries
Dr. A. J. Bakker, Klinisch chemicus,
St. Klinisch Chemisch Laboratorium,
Postbus 850,
8901 BR LEEUWARDEN.
Tel.: 058-2888444
Fax: 058-2882227
E-mail: [log in to unmask]
> -----Oorspronkelijk bericht-----
> Van: Fry, John [SMTP:[log in to unmask]]
> Verzonden: donderdag 26 februari 2004 17:23
> Aan: [log in to unmask]
> Onderwerp: Microalbumin screening - pre analytiical
>
> Do many laboratories or possibly GP surgeries screen for microalbumin
> using
> either dip sticks or any other system to reduce the massive increase that
> many are experiencing with microalbumin requests.
>
> If pre-analytical screening is undertaken, what kits are used?
>
> If laboratory analysis is then carried out, how are results reported - are
> both the urine creatinine, microalbumin and then the
> microalbumin/creatinine
> ratio reported on the results or merely the ratio?
>
> John Fry
>
> Worthing
>
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