RESUMEN
We aimed to develop a reliable, low cost method to assess the early stages of renal impairment in diabetes, for use in high-risk populations in countries with limited resources. We evaluated a trichloroacetic acid (TCA) turbidimetric method for microproteinuria screening in patients with diabetes. The method was compared with an immunoturbidimetric procedure for the detection of microalbumuniuria. Both methods performed within limits of allowable uncertainty based on inter- and intra-individual variation. A urinary albumin/creatinine ratio of 3.0 g/mol, assumed as diagnostic of microalbuminuria, was found to correlate with a cut-off value of 24 mg/L for microproteinuria. The clinical sensitivity and specificity of the TCA method determined against this ratio were 86% and 90% respectively. The reliability and practicability of the TCA method renders it suitable for the detection of early stage renal damage, with emphasis on screening high-risk populations in countries with limited resources.
Asunto(s)
Albuminuria/diagnóstico , Albuminuria/orina , Tamizaje Masivo/métodos , Nefelometría y Turbidimetría/métodos , Proteinuria/diagnóstico , Proteinuria/orina , Albuminuria/epidemiología , Albuminuria/etiología , Análisis Costo-Beneficio , Creatinina/orina , Países en Desarrollo , Diabetes Mellitus Tipo 2/complicaciones , Análisis Discriminante , Diagnóstico Precoz , Femenino , Humanos , Inmunoensayo/economía , Inmunoensayo/métodos , Inmunoensayo/normas , Fallo Renal Crónico/etiología , Masculino , Tamizaje Masivo/economía , Tamizaje Masivo/normas , Nefelometría y Turbidimetría/economía , Nefelometría y Turbidimetría/normas , Variaciones Dependientes del Observador , Valor Predictivo de las Pruebas , Prevalencia , Proteinuria/epidemiología , Proteinuria/etiología , Curva ROC , Factores de Riesgo , Sensibilidad y Especificidad , Manejo de Especímenes/métodos , Ácido TricloroacéticoRESUMEN
We aimed to develop a reliable, low cost method to assess the early stages of renal impairment in diabetes, for use in high-risk populations in countries with limited resources. We evaluated a trichloroacetic acid [TCA] turbidimetric method for microproteinuria screening in patients with diabetes. The method was compared with an immunoturbidimetric procedure for the detection of microalbumuniuria. Both methods performed within limits of allowable uncertainty based on inter- and intra-individual variation. A urinary albumin/creatinine ratio of 3.0 g/mol, assumed as diagnostic of microalbuminuria, was found to correlate with a cut-off value of 24 mg/L for microproteinuria. The clinical sensitivity and specificity of the TCA method determined against this ratio were 86% and 90% respectively. The reliability and practicability of the TCA method renders it suitable for the detection of early stage renal damage, with emphasis on screening high-risk populations in countries with limited resources