Department of Occupational Health, Graduate School of Medical Sciences, Kitasato University, Japan.
J Occup Health. 2012;54(3):176-80. doi: 10.1539/joh.11-0130-oa.
We evaluated the validity of the urine dipstick test for identifying reduced glomerular filtration rate (GFR) in male workers.
This study was conducted in male workers aged ≥ 40 yr. Reduced GFR was categorized as either estimated GFR (eGFR) < 60 ml/min/1.73 m(2) (eGFR <60) or eGFR < 50 ml/min/1.73 m(2) (eGFR < 50). Four sets of criteria were used to evaluate the GFR on the basis of proteinuria excretion, as measured using the urine dipstick test. Receiver operating characteristic curves were created based on the sensitivity and specificity and used to calculate the area under the curve (AUC) and the 95% confidence intervals (CI).
A total of 5,799 workers were included in this study. Use of an abnormal proteinuria criterion of 1+-3+ and a reduced GFR criterion of eGFR < 60 resulted in a sensitivity and specificity of 7.8% and 97.4%, respectively, while a reduced GFR criterion of eGFR < 50 resulted in a sensitivity and specificity of 37.8% and 97.4%, respectively. The AUC was 0.52 (95% CI, 0.48-0.55) for eGFR < 60 and 0.70 (95% CI, 0.59-0.80) for eGFR < 50.
In this study, 92.2% of participants with an eGFR < 60 and 62.2% of participants with an eGFR < 50 were overlooked in the urine dipstick test. These results suggest that the urine dipstick test only is not sufficient enough to identify reduced GFR and that both a urine dipstick test and other measures of GFR are required to reliably identify reduced GFR.
评估尿试纸检测男性工人肾小球滤过率（GFR）降低的有效性。
本研究纳入了年龄≥40 岁的男性工人。GFR 降低分为估算 GFR（eGFR）<60ml/min/1.73m²（eGFR<60）或 eGFR<50ml/min/1.73m²（eGFR<50）。使用尿试纸检测测量蛋白尿排泄情况，基于四种标准评估 GFR。根据敏感性和特异性创建了受试者工作特征曲线，用于计算曲线下面积（AUC）和 95%置信区间（CI）。
本研究共纳入了 5799 名工人。使用异常蛋白尿标准 1+至 3+和 eGFR<60 的降低 GFR 标准，敏感性和特异性分别为 7.8%和 97.4%，而使用 eGFR<50 的降低 GFR 标准，敏感性和特异性分别为 37.8%和 97.4%。eGFR<60 的 AUC 为 0.52（95%CI，0.48-0.55），eGFR<50 的 AUC 为 0.70（95%CI，0.59-0.80）。
在这项研究中，92.2%的 eGFR<60 患者和 62.2%的 eGFR<50 患者在尿试纸检测中被忽略。这些结果表明，仅尿试纸检测不足以识别 GFR 降低，需要尿试纸检测和其他 GFR 测量方法来可靠地识别 GFR 降低。
