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Dipsticks 'could miss microalbuminuria'

Dipstick testing is not a reliable method of identifying microalbuminuria in patients with type 2 diabetes, according to UK research.

The sensitivity of the Micral-Test, one of the two urine dipstick tests used in the study, was high, at 91.7% compared with a single laboratory albumin-creatinine ratio (ACR) measurement derived from the same urine sample. However specificity was low at 44%.

Microalbustix had a sensitivity of 33.3% when compared with an ACR measurement, but had a higher specificity of 92%.

Although testing costs would be reduced by using these dipstick tests rather than ACR, neither could reliably detect microalbuminuria, the authors said.

The data was collected from four practices in Oxford over six weeks. Each of the 98 participants made four visits to their local surgery at two-weekly intervals, giving a urine sample on each occasion.

The single laboratory ACR measurements taken for comparison to dipstick testing were based on NICE thresholds for microalbuminuria. 

Family Practice2012, available online 17 September

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