Kojima Chiari, Umemura Hiroshi, Shimosawa Tatsuo, Nakayama Tomohiro
Department of Clinical Laboratory, International University of Health and Welfare Mita Hospital, Tokyo, Japan.
Division of Laboratory Medicine, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo, Japan.
Front Med (Lausanne). 2023 Jun 26;10:1148698. doi: 10.3389/fmed.2023.1148698. eCollection 2023.
The urine protein dipstick test is widely used, but false-positive and false-negative results may occur. This study aimed to compare the urine protein dipstick test with a urine protein quantification method.
The data were extracted using the Abbott Diagnostic Support System, which analyzes the inspection results using multiple parameters. This study included 41,058 specimens tested using the urine dipstick test and protein creatinine ratio from patients aged ≥18 years. The proteinuria creatinine ratio was classified according to the Kidney Disease Outcomes Quality Initiative guidelines.
Urine protein on the dipstick test was negative in 15,548 samples (37.9%), trace in 6,422 samples (15.6%), and ≥1+ in 19,088 samples (46.5%). Among the trace proteinuria samples, A1 (<0.15 g/gCr), A2 (0.15-0.49 g/gCr), and A3 (≥0.5 g/gCr) category proteinuria accounted for 31.2, 44.8, and 24.0% of samples, respectively. All trace proteinuria specimens with a specific gravity of <1.010 were classified as A2 and A3 category proteinuria. In the trace proteinuria cases, women had a lower specific gravity and a higher percentage of A2 or A3 category proteinuria than men. The sensitivity in the "dipstick proteinuria" ≥ trace" group was higher than that in the "dipstick proteinuria ≥ 1+" group within the lower specific gravity group. The sensitivity in the "dipstick proteinuria ≥ 1+" group was higher for men than for women, and the sensitivity in the "dipstick proteinuria ≥ trace" group was higher than that in the "dipstick proteinuria ≥ 1+" group for women.
Pathological proteinuria assessment requires caution; this study suggests that evaluating the specific gravity of urine specimens with trace proteinuria is essential. Particularly for women, the sensitivity of the urine dipstick test is low, and caution is needed even with trace specimens.
尿蛋白试纸检测被广泛使用，但可能会出现假阳性和假阴性结果。本研究旨在比较尿蛋白试纸检测与尿蛋白定量方法。
使用雅培诊断支持系统提取数据，该系统使用多个参数分析检测结果。本研究纳入了41058份年龄≥18岁患者的尿液样本，这些样本同时进行了尿试纸检测和尿蛋白肌酐比值检测。蛋白尿肌酐比值根据肾脏病预后质量倡议指南进行分类。
尿试纸检测中，15548份样本（37.9%）尿蛋白为阴性，6422份样本（15.6%）为微量，19088份样本（46.5%）为≥1+。在微量蛋白尿样本中，A1（<0.15 g/gCr）、A2（0.15 - 0.49 g/gCr）和A3（≥0.5 g/gCr）类蛋白尿分别占样本的31.2%、44.8%和24.0%。所有比重<1.010的微量蛋白尿标本均被分类为A2和A3类蛋白尿。在微量蛋白尿病例中，女性的比重较低，A2或A3类蛋白尿的百分比高于男性。在低比重组中，“试纸蛋白尿≥微量”组的敏感性高于“试纸蛋白尿≥1+”组。“试纸蛋白尿≥1+”组中男性的敏感性高于女性，“试纸蛋白尿≥微量”组中女性的敏感性高于“试纸蛋白尿≥1+”组。
病理性蛋白尿评估需谨慎；本研究表明，评估微量蛋白尿尿液标本的比重至关重要。特别是对于女性，尿试纸检测的敏感性较低，即使是微量标本也需要谨慎对待。
