La microalbuminuria se define como una pequeña cantidad de proteína (albúmina) presente en la orina, en cantidades no evidenciables por los métodos tradicionales utilizados en el laboratorio, lo que hace imposible su captación a través de dichos procedimientos. La cuantificación de ésta es fundamental en el diagnóstico y seguimiento de las patologías renales. El objetivo de este estudio fue comparar tres métodos: la cinta reactiva, el método inmunoturbidimétrico y el método inmunológico de fase sólida (Nycocard), utilizando concentraciones conocidas para evidenciar cuál de éstos produce resultados reproducibles, exactos y fiables. Resumen:

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Available from: Vita Calzolaio, Oct 07, 2015
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    ABSTRACT: We tested the correlation of the albumin-to-creatinine ratio (A/C) in an early-morning urine sample, measured with a commercial kit (DCA 2000), with the conventional immunoturbidimetric determination in the laboratory and with overnight albumin excretion rate (reference method). Fifty-five type 1 diabetic adolescents had their first-morning urine collected on the 1st and 8th day of the period. Urinary albumin and creatinine were determined immediately using the DCA 2000 kit. Samples were also stored for laboratory analysis. To evaluate the correlation between early-morning urinary A/C ratio and overnight albumin excretion rate, 16 subjects had a timed overnight urine collection. A/C ratios determined with the DCA 2000 kit and by the laboratory method were 13.1 +/- 20.5 and 20.4 +/- 46.3 mg/g, respectively. A/C results by both methods proved to be strongly correlated (r = 0.98, P<0.001). DCA 2000-determined A/C showed 50% sensitivity and 100% specificity when compared to the reference method. Spot urinary A/C of the subset of 16 subjects significantly correlated with their overnight albumin excretion rate (r = 0.98, P<0.001). Intraindividual variation ranged from 17 to 32% and from 9 to 63% for A/C and overnight albumin excretion rate, respectively. In conclusion, an early-morning specimen should be used instead of timed overnight urine and the A/C ratio is an accurate, reliable and easily determined parameter for the screening of diabetic nephropathy. Immediate measurement of the A/C ratio is feasible using the DCA 2000 kit. Intraindividual variability indicates the need for repeated determinations to confirm microalbuminuria and the diagnosis of incipient diabetic nephropathy.
    Brazilian Journal of Medical and Biological Research 03/2002; 35(3):337-43. DOI:10.1590/S0100-879X2002000300008 · 1.01 Impact Factor
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    ABSTRACT: Microalbuminuria, defined as a urinary albumin excretion rate of 20-200 micrograms/min, predicts diabetic nephropathy and cardiovascular disease in diabetic patients. An increased urinary albumin excretion rate is probably also associated with cardiovascular disease in non-diabetic subjects. Thus, screening for microalbuminuria is of major importance. A semi-quantitative urinary dipstick method, Micral-Test, has been developed for this purpose. In a urine sample collected overnight from each of 1359 subjects the Micral-Test was evaluated with a quantitative ELISA-method as the standard. Sensitivity, specificity and diagnostic specificity in detecting microalbuminuria was 92, 58 and 12% respectively. The prevalence of microalbuminuria was 5.6%. In conclusion, the Micral-Test is highly sensitive in detecting microalbuminuria, but at the expense of a relatively high number of false positive tests.
    Ugeskrift for laeger 01/1994; 155(51):4155-7.
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    ABSTRACT: To analyse the validity of the Micraltest and Microbumintest semi-quantitative methods for microalbuminuria screening in type 2 diabetes mellitus in primary care clinics. Crossover study to validate diagnostic tests. Three general practices at an urban health centre. Consecutive sample of 64 diabetics not dependent on insulin. Each patient's own doctor performed in the consultation the semi-quantitative determinations in a simple sample of the morning's first urine. As standard, a rate of albumin excretion above 20 micrograms/min, determined by immunonephelometry in a 2-hour controlled time sample, was used. The prevalence of Microalbuminuria was 25% (C.I. 95%, 14.4-35.6). The sensitivity of Micraltest was 69% (CI, 42-88), and its specificity 52% (CI, 37-67), corresponding to the cut-off point of 10 mg/L. The sensitivity of Microbumintest was 63% (CI, 36-84), and its specificity 67% (CI, 52-79). The combination of both tests in one sample had 75% sensitivity (CI, 47-92) and 44% specificity (CI, 30-59). Negative predictive values ranged between 84 and 85%. The semi-quantitative microalbuminuria detection tests are of limited use in the primary care clinic. Their sensitivity and the negative predictive value obtained in an isolated sample do not seem acceptable for a screening method.
    Atención Primaria 01/1999; 22(10):631-5. · 0.95 Impact Factor
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