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COMPARACION DE TRES METODOS PARA LA DETERMINACION DE MICROALBUMINURIA

ABSTRACT 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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    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: Because of increased interest in the assay of albumin in urine and the sensitivity required to quantify concentrations associated with (a) increased risk of developing end-stage renal disease and cardiovascular disease among people with diabetes and (b) renal damage caused by exposure to nephrotoxic substances, we conducted a pilot study of the variation of these measurements within and among five laboratories that use various immunoassays. These assays included two different enzyme immunoassays, two different immunoturbidimetric assays, a fluorescent immunoassay, and a zone immunoelectrophoresis assay. The results indicate considerable variation both within and among laboratories for measurements at or near the normal range. Variability is equally attributable to the precision of individual immunoassays and to the variation of the mean values obtained by each laboratory. Individual laboratory CVs ranged from 5.8% to 18.2% for mid- and high-concentration samples treated with preservative and from 8.4% to 23.6% for mid- and high-concentration samples containing no preservative. The relative bias of individual laboratory means ranged from -56.4% to 20.5% for the two preserved materials and from -32.6% to 0.8% for the two materials containing no preservative. To reduce the chance of misdiagnosing the risk associated with above-normal albumin concentrations in urine, we need to address the problems contributing to imprecision and inaccuracy, particularly laboratory-to-laboratory variability.
    Clinical Chemistry 03/1991; 37(2):191-5. · 7.15 Impact Factor
  • Comparison of methods for urinary albumin determination in patients with type 1 diabetes. C Khawal, R Sesso, M Almeida, M Figueiro, J Bordin . Braz J Med Biol Res 35 337-343.

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