Hodel Nikolai Carl, Rentsch Katharina M, Paris Daniel Henry, Mayr Michael
Medical Outpatient Department, University Hospital Basel, University Basel, Basel, Switzerland; Swiss Tropical and Public Health Institute, University Basel, Basel, Switzerland.
Laboratory Medicine, University Hospital Basel, University Basel, Basel, Switzerland.
Am J Kidney Dis. 2025 May;85(5):618-628. doi: 10.1053/j.ajkd.2024.09.017. Epub 2024 Dec 18.
Proteinuria plays a central role in the diagnosis of kidney disease and has a high prognostic value. The test methods used differ considerably regarding their impact on test accuracy, sensitivity, and specificity. Therefore, knowledge of the methodology is crucial for the interpretation of the results. In addition to the distinction between semiquantitative and quantitative tests, there are also relevant differences within the 2 methods. In general, semiquantitative tests are easy to handle but have limitations such as incomplete quantification, a lack of specificity regarding the type of proteinuria, and a high rate of false-positive results that require retesting with a quantitative method for verification. In contrast, quantitative methods, especially immunoassays, have the advantages of high test accuracy and the possibility of targeted detection of specific protein molecules in addition to albumin. However, these methods are more expensive and require access to a laboratory or an electronic point-of-care device. In this Review, the different types of tests for proteinuria and their underlying methodologies and strengths and weaknesses are discussed in detail to allow a rational decision of use and the correct interpretation of the results depending on the clinical context.
蛋白尿在肾脏疾病的诊断中起着核心作用，并且具有很高的预后价值。所使用的检测方法在对检测准确性、敏感性和特异性的影响方面差异很大。因此，了解检测方法对于结果的解读至关重要。除了半定量检测和定量检测之间的区别外，这两种方法内部也存在相关差异。一般来说，半定量检测易于操作，但存在一些局限性，如定量不完全、对蛋白尿类型缺乏特异性以及假阳性率高，需要用定量方法重新检测以进行验证。相比之下，定量方法，尤其是免疫测定法，具有检测准确性高以及除白蛋白外还能靶向检测特定蛋白质分子的优点。然而，这些方法成本更高，需要使用实验室设备或电子即时检测设备。在本综述中，将详细讨论蛋白尿的不同检测类型及其基本方法、优缺点，以便根据临床情况合理决定检测方法的使用并正确解读结果。
