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Saudi Journal of Kidney Diseases and Transplantation
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LETTER TO THE EDITOR  
Year : 2012  |  Volume : 23  |  Issue : 4  |  Page : 841-843
Classical laboratory and point of care tests for screening for microalbuminuria


Project Coordinator, Thai POCT Forum, Bangkok, Thailand

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Date of Web Publication9-Jul-2012
 

How to cite this article:
Wiwanitkit V. Classical laboratory and point of care tests for screening for microalbuminuria. Saudi J Kidney Dis Transpl 2012;23:841-3

How to cite this URL:
Wiwanitkit V. Classical laboratory and point of care tests for screening for microalbuminuria. Saudi J Kidney Dis Transpl [serial online] 2012 [cited 2020 Dec 3];23:841-3. Available from: https://www.sjkdt.org/text.asp?2012/23/4/841/98181
To the Editor ,

Screening for urine protein is accepted as an important test in nephrology. [1],[2],[3] At present, de­termination of microalbuminuria is a recom­mended screening test for the patients with diabetes mellitus and hypertension. [4],[5],[6] Accor­ding to the present guidelines, the determina­tion of urine protein-creatinine ratio becomes an important part of nephrology practice. [6],[7],[8]

The schematic diagram describing the flow of these processes can be seen in [Figure 1].
Figure 1: The schematic diagram describing the flow of analytical processes according to the clinical practice guideline.[6]

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We performed a comparative study between two approaches: (a) classical laboratory ana­lysis and (b) point of care testing analysis, in which we used AUTION Sticks10 PA for determination of urine microalbumin; the point of care urine strip reader, Pocket Chem UA was also used. The comparison focused on cost and turnaround time. The cost was de­rived from the standard referencing laboratory in Bangkok, Thailand and presented in US dollar (1 US dollar = 30 Thai baht). Also, the cost of urine analyzer was not included. For the turnaround time, it is calculated from the turn around time of the analyzer and specimen transportation time between the processes within the guideline.

The identified cost and turnaround time of each alternative approach is shown in [Table 1] and [Table 2], respectively. After adjustment to the unit turnaround time, the costs for clas­sical laboratory analysis and (b) point of care testing analysis are equal to 6.6 US dollar and 4.2 US dollar, respectively.
Table 1: Cost of each microalbuminuria detection approach.

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Table 2: Turnaround time of each alternative approach.

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Some practices such as urine protein strip determination without determination of urine protein-creatinine ratio or urine albumin- creatinine ratio (microalbuminuria) are not acceptable at present. [7],[8] To yield a clinically useful screening, the standard practice guide­line in screening must be implemented. [6]

At present, the use of point of care testing seems to be an important emerging tool that challenges the practice according to the scree­ning protocol. The query on which approach, classical or point of care tests, is more appro­priate requires systematic appraisal. The unit cost identification reveals that the use of the point of care test approach is more costly than the classical test. However, the point of care test provides a significant reduction of turn­around time, which is the core concept of point of care, which may be more appealing for a large population screening. [9]


   Acknowledgment Top


The author would like to thank Connect Diagnostics, Thailand, which is the main supportive agency to the Thai POCT forum.

 
   References Top

1.Cirillo Cirillo M. Evaluation of glomerular fil­tration rate and of albuminuria/proteinuria. J Nephrol 2010;23:125-32.  Back to cited text no. 1
    
2.Rosner MH. Urinary biomarkers for the detec­tion of renal injury. Adv Clin Chem 2009;49: 73-97.  Back to cited text no. 2
[PUBMED]    
3.Polkinghorne KR. Detection and measurement of urinary protein. Curr Opin Nephrol Hypertens 2006;15:625-30.  Back to cited text no. 3
[PUBMED]  [FULLTEXT]  
4.Lamb EJ, MacKenzie F, Stevens PE. How should proteinuria be detected and measured? Ann Clin Biochem 2009;46(Pt 3):205-17.  Back to cited text no. 4
    
5.Berry J. Microalbuminuria testing in diabetes: is a dipstick as effective as laboratory tests? Br J Community Nurs 2003;8:267-73.  Back to cited text no. 5
[PUBMED]  [FULLTEXT]  
6.Snyder S, Pendergraph B. Detection and eva­luation of chronic kidney disease. Am Fam Physician 2005;72:1723-32.  Back to cited text no. 6
[PUBMED]  [FULLTEXT]  
7.Miller WG, Bruns DE, Hortin GL, et al. National Kidney Disease Education Program-IFCC Working Group on Standardization of Albumin in Urine. Current issues in measure­ment and reporting of urinary albumin excre­tion. Clin Chem 2009;55:24-38.   Back to cited text no. 7
[PUBMED]  [FULLTEXT]  
8.Miller WG, Bruns DE, Hortin GL, et al. National Kidney Disease Education Program-IFCC Working Group on Standardization of Albumin in Urine. Current issues in measurement and reporting of urinary albumin excre­tion. Ann Biol Clin (Paris) 2010;68:9-25.   Back to cited text no. 8
[PUBMED]  [FULLTEXT]  
9.Wiwanitkit V. Analysis on weight-turnaround time properties for point-of-care testing tool for microalbumin determination: Implication for using in distanced site. Ren Fail 2010; 32:533-4.  Back to cited text no. 9
[PUBMED]  [FULLTEXT]  

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Correspondence Address:
Viroj Wiwanitkit
Project Coordinator, Thai POCT Forum, Bangkok
Thailand
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DOI: 10.4103/1319-2442.98181

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