Paul,
This is an interesting move. A concern I would have is that you will be
missing those who have Bence Jones Protein (free light chains) in their
urine. Not totally uncommon in renal disease.
We had an example the other week where the dipstick for total protein
consistently read negative for total protein. A formal total protein was
accidentally requested which showed 2.5g/L protein present. This turned
out to be almost entirely free kappa light chains. The result
significantly changed the patient management. Apparently the dipstick
total protein does not detect light chains.
Screening with just an albumin measurement will certainly miss these.
Greg
Greg Watts MSc MA
Deputy Director
SYDNEY ADVENTIST HOSPITAL PATHOLOGY
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_______________________________________
-----Original Message-----
From: Clinical biochemistry discussion list
[mailto:[log in to unmask]] On Behalf Of Paul Thomas
Sent: Thursday, 12 February 2009 4:12 AM
To: [log in to unmask]
Subject: urine albumin creatinine ratio (ACR)
With the recent CKD guidelines there was a recommendation to move away
from reagent strips to detect proteinuria and switch from protein
creatinine
Ratio to ACR as the primary screening test for proteinuria....
Paul
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