Screening strategies in the detection of microalbuminuria in insulin‐dependent diabetic patients

A dipstick immunochemical method (Micral‐Test®) and albumin:creatinine ratios were compared with Urinary Albumin Excretion Rates (UAER) measured in an overnight urine specimen in the early detection of microalbuminuria in IDDM patients. One hundred and nine patients (59 men and 50 women) who had IDDM for at least five years, tested negative for proteinuria and had no history of hypertension were asked to provide early morning (EMU), random and overnight urine samples, Micral‐Test®, urine albumin:creatinine rations, and albumin excretion rates were assessed. All Micral‐Test® results were read by a single observer. In the detection of subjects with UAER>20μg/min, Micral‐Test® in an EMU sample had a sensitivity of 87.5% and specificity of 95.1%. Albumin:creatinine ratio (predictive value>3.6mg/mmol) in an EMU sample has a sensitivity of 87.5% and specificity of 92.1%; in random urine sample values of 84.6% and 80.7% were obtained respectively. Both Micral‐Test® and albumin: creatinine ratios in EMU samples have high negative predictive values (97.5% and 97.2% respectively). Micral‐Test® and albumin:creatinine ratio in an early morning urine sample may be acceptable alternative methods for screening for microalbuminuria.