2011 Top Game Changers in Nephrology

George Bakris, MD; Jeffrey S. Berns, MD; Lynda A. Szczech, MD; Carol Peckham


November 16, 2011

In This Article

5. The Dipstick: A Simple Test With Major Implications for Kidney Function

A prospective observational study from Clark and colleagues[8]followed 3371 participants longitudinally with yearly blood and urine samples addressing these key questions:

  • What is the difference between microalbuminuria, albuminuria, and proteinuria?

  • When do you use a urine dipstick to screen vs an albumin-to-creatinine ratio (ACR) vs a protein-to-creatinine ratio?

  • What exactly are we screening for?

In her monthly Medscape Viewpoint, Lynda Szczech wrote, "Among the entire cohort, the likelihood of developing rapid kidney function decline (RKFD) was 3.2 times greater among those with albuminuria as compared with those without. When persons with at least trace proteinuria were compared with those without proteinuria on dipstick, the likelihood of RKFD was 3.7 times greater in those with trace proteinuria, which was comparable to using albuminuria as the screening test. While the Chronic Kidney Disease Prognosis Consortium suggests that albuminuria is an important tool in identifying individuals at risk for renal outcomes, the study presented here by Clark and colleagues is the first to compare ACR with dipstick in a head-to-head manner. These results suggest that the use of the urine dipstick to identify people with at least trace proteinuria is more effective in screening for individuals who will go on to lose significant amounts of kidney function in the short term."

Read the complete Viewpoint on this study from Lynda Szczech, MD.


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