Results of proteinuria measurement using semiquantitative dipstick in children with fever or nephrotic syndrome

Main Article Content

Chatidjah Alaydrus
Yati Soenarto
M. P. Damanik

Abstract

Background Proteinuria is a major determinant of the progression
of renal disease. Quantitative measurement of proteinuria within
a 24-hour period of urine collection was the accepted method of
evaluation, but is tedious and prone to error in the absence of a
reliable collection. We evaluated the diagnostic value of AUTION
Sticks 10 TA to diagnose proteinuria in children with fever and
nephrotic syndrome.
Methods This study was conducted at the pediatric ward of Sardjito
Hospital. Proteinuria levels were measured using semiquantitative
dipstick methods with AUTION Sticks 10 TA using a 24-hour
urine sample collected at the first examination until the following
day. Proteinuria level was also measured by Esbach method as gold
standard.
Results A total of 120 children aged 16 years old were recruited. In
the fever group, AUTION Sticks 10 TA couldn’t be used for the
diagnostic test. AUTION Sticks 10 TA +2 to diagnose intermediate
proteinuria produced a sensitivity of 60%, a specificity of 89%, a
positive predictive value of 43% , a negative predictive value of
94%, a positive likelihood ratio of 5.4, a negative likelihood ratio of
0.45. To diagnose nephrotic proteinuria, AUTION Sticks 10 TA
+3/+4 produced a sensitivity of 90%, a specificity of 91%, a positive
predictive value of 96%, a negative predictive value of 77%, a
positive likelihood ratio of 10, a negative likelihood ratio of 0.11.
Conclusion AUTION Sticks 10 TA +2 is sufficiently accurate
for a diagnostic test of intermediate proteinuria (Esbach value)
while +3/+4 is sufficiently accurate for a diagnostic test of
nephrotic proteinuria (Esbach value) in children. In the fever
group, dipstick result can not explain the Esbach value.

Article Details

How to Cite
1.
Alaydrus C, Soenarto Y, Damanik M. Results of proteinuria measurement using semiquantitative dipstick in children with fever or nephrotic syndrome. PI [Internet]. 29Feb.2008 [cited 22Nov.2019];48(1):10-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/444
Section
Articles
Author Biographies

Chatidjah Alaydrus

Department of Child Health, Medical School, Gadjah Mada
University, Yogyakarta, Indonesia.

Yati Soenarto

Department of Child Health, Medical School, Gadjah Mada
University, Yogyakarta, Indonesia.

M. P. Damanik

Department of Child Health, Medical School, Gadjah Mada
University, Yogyakarta, Indonesia.
Received 2016-09-04
Accepted 2016-09-04
Published 2008-02-29

References

1. Srivastava RN. Isolated asymptomatic proteinuria. Indian
Journal Pediatric 2002;69:1055-8.
2. Loghman M. Evaluating proteinuria in children. American
Academy of Family Physician 1998;58:1-11.
3. Hogg RJ, Portman RJ, Milliner D. Evaluation and management
of proteinuria and nephrotic syndrome in children:
recommendations from a pediatric nephrology panel
established at the National Kidney Foundation conference
on proteinuria, albuminuria, risk, assessment, detection and
elimination (PARADE). Pediatrics 2000;105:1242-9.
4. The CARI Guidelines–Caring for Australians with Renal
Impairment, 2004. Urine Protein as Diagnostic Test in Urine
Protein as Diagnostic Test.
5. Bergstein J. Conditions particularly associated with
proteinuria. In: Behrman RE, Kliegman RM, Arvin AM,
editors. Nelson Textbook of Pediatrics. 15 th ed. Philadelphia:
W.B. Saunders Company; 2002. p. 1590-3.
6. Agarwal I, Kirubakaran C, Markandeyulu, Selvakumar.
Quantitation of proteinuria by spot urine sampling. Indian
Journal of Clinical Biochemistry 2004;19:45-7.
7. National Kidney Foundation. Testing for Proteinuria: Time
for a Change. Am J Kidney Dis 2003;1:1.
8. Iseki K, Iseki C, Ikemiya Y. Risk of developing end-stage renal
disease in a cohort of mass screening. Kidney Int 1996;49:800–5.
9. Assadi FK. Quantitation of microalbuminuria using random
urine samples. Pediatric Nephrology 2002;17:107-10.
10. Wirya IGNW. Proteinuria. In: Alatas H, Tambunan T,
Trihono PP, Pardede S.O, editors. Buku Ajar Nefrologi Anak.
Jakarta: Bagian Ilmu Kesehatan Anak FKUI; 2002.
11. Wirawan R. Evaluasi pemeriksaan Kimia Urin: Uji Carik Celup
AIM URI Dan Stabilitas Bahan Kontrol KOVA-TROL dengan
Alat Clinitek 100. Jakarta: Bagian Patologi Klinik FK UI; 2001.
12. Free HM. Chemical Measurement in Manual Modern Urine
Chemistry. USA: Miles Inc; 1991.
13. Abitbol C, Zilleruelo G, Freundlich M, Strauss J. Quantitation
of proteinuria with urinary protein/creatinine ratios and
random testing with dipsticks in nephrotic children. Journal
Pediatric 1990;116:243-7.
14. Penders J, Fiers T, Delanghe JR. Quantitative evaluation of
urinalysis test strips. Clinical Chemistry 2002;48:2236-41.
15. Fletcher RH, Fletcher SW, Wagner EH. Clinical Epidemiology.
The Essentials. 3 rd ed. Baltimore: Williams and Wilkins;
1998.p. 65-70.
16. Rupprecht HD. Differential Diagnosis of proteinuria. MMW
Fortschr Medical 2004;146:41-5.
17. Stojimirovic B, Petrovic D. Proteinuria: the diagnostic
strategy based on determination of various urinary protein.
Srp Arh Celok Lek 2004;132:127-32.