Detecting proteinuria: A comparison of diagnostic tests

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Jeanida Mauliddina
Rosmayanti Siregar
Oke Rina Ramayani
Rafita Ramayati
Rusdidjas Rusdidjas


Background Proteinuria is a condition when protein is found in urine, a common symptom in children with renal disorders. Proteinuria can also be found in nonnal children and in those with non-renal disorders. A high sensitivity test is needed to detect proteinuria. Spectrophotometry has been used as a standard to detect proteinuria, however, it is expensive and not readily available in health clinics. We tested the use of20% sulfosalicylic add to detect proteinuria, and compared it to spectrophotometry. The sulfosalicylic add test is inexpensive, rapid, and easily performed in primary community health centers.

Objective To compare 2 0 % sulfosalicylic acid test t o spectrophotometry as a diagnostic test for proteinuria.

Methods We conducted a cross-sectional study in Adam Malik Hospital from September 2009 until December 2009. Inclusion criteria were children aged 3 to 18 years who experienced kidney disease. We collected 24 hour urine specimens from 55 children by consecutive sampling. Urine specimens were tested for proteinuria by 20% sulfosalicylic acid test and spectrophotometry.

Results Sensitivity and specificity of 20% sulfosalicylic acid test compared to spectrophotometry were 88.1 % and 69.2%, respectively, with a positive predictive value and a negative predictive value of 90.2% and 64.3%, respectively.

Conclusion The sulfosalicylic acid test had low sensitivity and specificity for detecting proteinuria, but it was more practical and less expensive compared to spectrophotometry.

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How to Cite
Mauliddina J, Siregar R, Ramayani O, Ramayati R, Rusdidjas R. Detecting proteinuria: A comparison of diagnostic tests. PI [Internet]. 28Feb.2011 [cited 18Oct.2019];51(1):17-1. Available from:
Received 2016-10-17
Accepted 2016-10-17
Published 2011-02-28


1.. Wila Wirya ION. Proteinuria .. In: Alatas H, Tambunan T, Trihono PP, Pardede SO, editors. Buku ajar nefrologi anak. 2nd Ed. Jakarta: Balai Penerbit FK UI; 2006. p.127-41.
2.. Delaney MP, Price CP, Lamb E. Kidney disease. In: Burtis CA, Ashwood ER, Bruns DE, editors.Tietz textbook of clinical chemistry and molecular diagnostics. 4th Ed. New Delhi: Elsevier; 2006. p.1671-89.
3.. Schumann OB, Schweitzer Sc. Examination of urine. In: Hendry JB, editor. Clinical diagnosis and management by laboratory methods. 18th Ed. New York: WB Saunders; 1991. p.387-90.
4.. Lamb E, Price CPO. Kidney function tests. In: Burtis CA, Ashwood ER, Bruns DE, editors. Tietz textbook of clinical chemistry and molecular diagnostics. 4th Ed. New Delhi: Elsevier; 2006. p.797-826.
5.. Keane WE. Proteinuria: its clinical importance and role in progressive renal disease. Am J Kidney Dis. 2000;35:s97- s105.
6.. Zhao S, EzraJB, Mcpherson RA. Basic examination of urine. In: Zhao S, editor. Henry's clinical diagnosis and management by laboratory methods. 21th Ed. New York: Elsevier; 2007. p.393-425.
7.. Milford DV, Robson AM. The child with abnonnal urinalysis, haematuria and/or proteinuria. In: Webb NJ, Postlethewaite RJ, editors. Clinical paediatric nephrology. 3rd Ed. New York: Oxford University Press; 2003. p.1-27.
8. Makker SP. Proteinuria. In: Kher KK, Makker Sp, editors. Clinical pediatric nephrology. Singapore: Mc Graw Hill; 1992, p.117-36.
9. Agarwal I, Kirubakaran C, Markandeyulu, Selvakumar. Quantitation of proteinuria by spot urine sampling. Indian J Clin Biochem. 2004;19:55-7.
10. Oni MO, Oguntibeju O. Clinical and diagnostic importance of proteinuria: a review. Afr J Biotechnol. 2008; 7:3166-72.
11. Kashif W, Siddiqi N, Dincer HE, Dincer Ap, Hirsch S. Proteinuria: how to evaluate an important finding. Cleveland Clin J Med. 2003;70,535-47.
12. Adham ML. Evaluation proteinuria in children. Am Fam Physician. 1998;58:1145-52.
13. Milford DY. Investigating haematuria and proteinuria. Paediatr Child Health. 2008;18:349-353.
14. Narchi H. Assessment and management of non-nephrotic range proteinuria in children. Sri Langka J Child Health. 2009;37:85-92.
15. Christian MT, WatsonAR. The investigation of proteinuria. CUff Paediatr. 2004;14:547-55.
16. Serdaroglu E, Mir S. Protein-osmolality ratio for quantification of proteinuria in children. Clin Exp Nephrol. 2008;12,354-7.
17. Wilde HM, Banks D, Larsen CL, Connor G, wallace D, Lyon ME. Evaluation of the bayer microalbumin/creatinine urinalysis dipstick. Clin Chimica Acta. 2008;393 :110-13.
18. Fischbach FT, Dunning MB, editors.U rine studies.A manual of laboratory and diagnostic test. 7th Ed. Philadelphia: Lippincott Williams&Wilkins, 1996; p. 164-263.
19. Pegoraro A, Singh A, Bakir AA, Arruda JA, Dunca G. Simplified screening for microalbuminuria. Ann Intern Med. 1997 ;127,817-19.
20. Lin CY, Hsieh CC, Chen Wp, Yang LY, Wang HH. T he underlying diseases and follow-up in Taiwanese children screened by urinalysis. Pediart Nephrol. 2001; 16:232-7.
21. Fogazzi GB, Verdesca S, Garigali G. Urinalysis: core curriculum 2008. Am) Kidney Dis. 2008;51:1052-67.
22. Jahan S, Islam MS, Hossain MM. Spot urinary protein/ osmolality ratio as a predictor for proteinuria of nephritic range. Bangladesh Med Res Counc Bull. 2007;33:65-8.
23. Zhai YH, Xu H, Zhu GH, Wei MJ, Hua BC, Shen Q, et all. Efficacy of urine screening at school: experience in Shanghai, China. Pediatr Nephrol. 2007;22:2073-9.
24. Gyure WL. Comparison of several methods for semiquantitative determination of urinary protein. Clin Chem. 1977;23:876-9.
25. Murakami M, Hayakawa M, Yanaghira T, Hukunaga Y. Proteinuria screening for children. Kidney Internat. 2005;67:s23-7.
26. Grinstead GF, Scott RE, Stevens BS, Ward VL, Wilson DM. T he ames clinitek 200/multistix 9 urinalysis method compared \\lith manual and microscopic methods. Clin Chem. 1987;33:660-2.
27. Lane MK, Pearce RH. Test protinuria a comparison of two new commercial products with standart tests. Canada M A J.1958;15:843-5.
28. Aitman KA, Stellate. Variation of protein content of urine in a 24 hour period. Clin Chem. 1963;9:63-9.
29. Priyana A. Urinalisa. Patologi klinik. Jakarta: Penerbit Universitas Trisakti, 2007; p. 47-58.
30. Lyon SD, Sanderson MW, Vaden SL,Lappin MR,Jensen WA, Grauer GF. Comparison of urine dipstick, sulfosalicylic acid, urine protein-to-creatinine ratio, and species-specific ELISA methods for detection of albumin in urine samples of cats and dogs. J Am Vet Med Assoc. 2010;236:874-9.
31. Dilena BA, Panberthy LA, Fraser CG. Six methods for determining urinary protein compared. Clin Chem. 1983;29:553-7.