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Vol. 59. Núm. 2.
Páginas 131-137 (Agosto 2003)
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Vol. 59. Núm. 2.
Páginas 131-137 (Agosto 2003)
Acceso a texto completo
Evaluación de dos métodos rápidos para la determinación de microalbuminuria y de la relación albúmina/creatinina en orina
Evaluation of two rapid tests for the determination of microalbuminuria and the urinary albumin/creatinine ratio
Visitas
...
V. Ostaa,
Autor para correspondencia
viosta@ciudad.com.ar

Correspondencia: Dra. V. Osta. Zapata, 31. Piso 2.° Dpto. A (1426). Capital Federal. Buenos Aires. Argentina.
, V. Natolia, S. Diéguezb
a Laboratorio Central. Hospital de Niños Dr. Ricardo Gutiérrez. Buenos Aires. Argentina
b Servicio de Nefrología. Hospital de Niños Dr. Ricardo Gutiérrez. Buenos Aires. Argentina
Información del artículo
Objetivo

La detección de microalbuminuria está justificada desde el punto de vista coste-beneficio en aquellos pacientes que presentan riesgo de desarrollar una lesión renal, en una etapa en la cual el proceso es aún reversible. En este estudio se evalúan los analizadores DCA 2000 y Clinitek 50 (Bayer Ò) que determinan simultáneamente albúmina y creatinina en orina para adoptarlos como métodos rápidos para la detección de microalbuminuria.

Métodos

Se analizaron 127 muestras de orina de pacientes pediátricos con diferentes enfermedades. Se determinaron la albúmina, la creatinina y la relación albúmina/creatinina en el analizador DCA 2000 y con las tiras Clinitek-microalbuminuria leídas en el analizador Clinitek 50, y se los comparó con los métodos utilizados habitualmente en el laboratorio.

Resultados

El coeficiente de correlación entre albúmina por nefelometría frente a DCA 2000 fue de 0,914, para creatinina por el método de Jaffe frente DCA 2000 de 0,970 y para la relación albúmina/creatinina calculada frente a DCA 2000 de 0,839. Considerando una concentración de albúmina de 30 mg/l como valor de corte para considerar una muestra como patológica, la sensibilidad, especificidad, los valores predictivos positivo y negativo para la detección de microalbuminuria en el DCA 2000 fueron de 100, 93, 84 y 100 %; y para el Clinitek 50 de 91,7, 86, 55 y 98 %, respectivamente. El análisis de las curvas ROC mostró una mayor utilidad diagnóstica del DCA 2000 para la detección de microalbuminuria.

Conclusiones

El analizador DCA 2000 muestra una buena correlación para albúmina y creatinina cuando se los compara con los métodos considerados de referencia, siendo la obtención inmediata de los resultados una ventaja importante. Las tiras Clinitek-microalbuminuria representan un método semicuantitativo, sencillo y de bajo coste para ser utilizado como prueba tamiz para la detección de microalbuminuria, no siendo útil para el seguimiento.

Palabras clave:
Microalbuminuria
Nefropatía incipiente
Relación albúmina/ cratinina
Prueba tamiz
Objective

Microalbuminuria screening is justified on the grounds of its cost-benefit ratio in patients at risk of kidney damage while the process is still reversible. The aim of the present study was to evaluate the DCA 2000 analyser and the Clinitek 50 system (Bayer), which simultaneously measure urinary albumin and creatinine levels to adopt them as rapid methods for microalbuminuria detection.

Methods

One hundred twenty-seven urine samples from pediatric patients with various disorders were assessed. Albumin, creatinine, and the albumin/creatinine ratio were determined using the DCA 2000 analyzer and the Clinitek 50 system, which were compared against the usual reference laboratory methods.

Results

The correlation coefficient of nephelometric values vs the DCA 2000 analyzer was 0.914 for albumin, 0.970 for creatinine and 0.839 for the albumin/creatinine ratio. At an albumin cut-off concentration of 30 mg/l, the sensitivity, specificity, positive predictive value and negative predictive value were 100 %, 93 %, 84 % and 100 % for the DCA 2000 analyzer and 91.7 %, 86 %, 55 % and 98 % for the Clinitek 50 system. ROC curve analysis showed that the DCA 2000 system was more effective than the Clinitek 50 in microalbuminuria screening.

Conclusions

The data obtained with the DCA 2000 system showed close agreement with those obtained with reference laboratory methods. The immediate availability of results is a great advantage in clinical practice. The Clinitek-Microalbumin dipstick system is a semiquantitative method that is easy to use, low in cost, simple and useful for screening, but it is less reliable as a follow-up method.

Key words:
Microalbuminuria
Incipient nephropathy
Albumin/creatinine ratio
Screening
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