Concordance of Proteinuria Examination Results using Dipstick Urine, Albumin-Creatinine Ratio, and Immunoassay in Diabetes Mellitus Type-2

Abstract

Periodic examination of proteinuria for DM patients is important for the prevention of diabetic nephropathy complications. The most commonly used methods for checking proteinuria today are urine dipstick, albumin-creatinine ratio, and immunoassays. To analyze the suitability of proteinuria examination using a urine Dipstick, Albumin-Creatinine Ratio, and immunoassay. An observational analytic study, cross sectional, conducted in July 2020 - October 2020 at the Dr. Soetomo Surabaya, using urine samples (n = 57) that met the inclusion and exclusion criterias. The suitability test was carried out between the AIM urine dipstick, urine sysmex dipstick, AIM immunoassay and the Sysmex UC 3500 AC Ratio which were analyzed by the Cohen's kappa test. Immunoassay detected the highest proteinuria in 85.96% of type 2 DM patients, followed by AC Ratio (68.42%), AIM Dipstick (52.6%), and Sysmex Dipstick (49.12%). There was a very strong agreement between the AIM Dipstick and the Sysmex Dipstick, κ = 0.86 (p<0.05), a weak agreement between AIM immunoassay examination and Sysmex AC ratio, κ = 0.37 (p<0.05). There is no agreement between the Sysmex urine disptick and AIM immunoassay. There is a low agreement between the AIM Dipstick and the Sysmex AC Ratio. The AIM immunoassay detected microalbuminuria in 10(55.6%) of 18 subjects with negative results on Sysmex. Most immunoassay examinations detect proteinuria in type 2 DM patients. It is advisable to screen proteinuria using an immunoassay examination in type 2 DM patients1. Immunoassay examination can be relied on in screening proteinuria in DM patients. The results showed a very strong agreement using the AIM and the Sysmex dipstick examination. However, there was a weak agreement between the immunoassay examination and the AC ratio.