Test Characteristics of Urine Dipstick for Identifying Renal Insufficiency in Patients with Diabetes
Objective: To evaluate the test characteristics of the urine dipstick as a screening tool for elevated serum creatinine in patients with uncontrolled diabetes mellitus in the emergency department (ED).Methods: Patients with diabetes over the age of 18 who presented to the ED for any complaint over a...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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eScholarship Publishing, University of California
2011-05-01
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| Series: | Western Journal of Emergency Medicine |
| Subjects: | |
| Online Access: | http://escholarship.org/uc/item/50j700d1 |
| _version_ | 1818450053411373056 |
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| author | Arora, Sanjay Long, Theodore Menchine, Michael |
| author_facet | Arora, Sanjay Long, Theodore Menchine, Michael |
| author_sort | Arora, Sanjay |
| collection | DOAJ |
| description | Objective: To evaluate the test characteristics of the urine dipstick as a screening tool for elevated serum creatinine in patients with uncontrolled diabetes mellitus in the emergency department (ED).Methods: Patients with diabetes over the age of 18 who presented to the ED for any complaint over a three-month study period were considered eligible for participation in this study. A finger-stick blood glucose of ≥250 mg/dL at triage was used to confirm the diagnosis of uncontrolled diabetes. After obtaining written consent, each patient had a urine dip performed and a chemistry panel drawn. Any level of proteinuria on the urine dip was considered to be a positive test. Based on the laboratory and clinical guidelines at our institution, renal insufficiency was defined as creatinine concentration of greater than 1.3 mg/dL.Results: Three Hundred ninety-three confirmed patients with uncontrolled diabetes were enrolled in this study, and 49 of these (12.5%) were found to have renal insufficiency. The sensitivity and specificity of the urine dip for predicting renal insufficiency were 69.4% (95% confidence interval [CI] 54.6-81.7%) and 57.8% (95%CI 52.4-63.1%) respectively. The positive predictive value was 19% (95%CI 13.5-25.5%), and the negative predictive value was 93% (95%CI 88.7-96%). The positive likelihood ratio was 1.65 (95%CI 1.32-2.06) and the negative likelihood ratio was 0.53 (95%CI 0.34-0.81).Conclusion: In this cohort of patients with uncontrolled diabetes, the test characteristics of the urine dipstick make it a poor screening tool for renal insufficiency in the ED. [West J Emerg Med. 2011;12(2):250-253.] |
| first_indexed | 2024-12-14T20:45:11Z |
| format | Article |
| id | doaj.art-d725314e105f4646b6d05b48e1907a21 |
| institution | Directory Open Access Journal |
| issn | 1936-900X 1936-9018 |
| language | English |
| last_indexed | 2024-12-14T20:45:11Z |
| publishDate | 2011-05-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Western Journal of Emergency Medicine |
| spelling | doaj.art-d725314e105f4646b6d05b48e1907a212022-12-21T22:48:05ZengeScholarship Publishing, University of CaliforniaWestern Journal of Emergency Medicine1936-900X1936-90182011-05-01122250253Test Characteristics of Urine Dipstick for Identifying Renal Insufficiency in Patients with DiabetesArora, SanjayLong, TheodoreMenchine, MichaelObjective: To evaluate the test characteristics of the urine dipstick as a screening tool for elevated serum creatinine in patients with uncontrolled diabetes mellitus in the emergency department (ED).Methods: Patients with diabetes over the age of 18 who presented to the ED for any complaint over a three-month study period were considered eligible for participation in this study. A finger-stick blood glucose of ≥250 mg/dL at triage was used to confirm the diagnosis of uncontrolled diabetes. After obtaining written consent, each patient had a urine dip performed and a chemistry panel drawn. Any level of proteinuria on the urine dip was considered to be a positive test. Based on the laboratory and clinical guidelines at our institution, renal insufficiency was defined as creatinine concentration of greater than 1.3 mg/dL.Results: Three Hundred ninety-three confirmed patients with uncontrolled diabetes were enrolled in this study, and 49 of these (12.5%) were found to have renal insufficiency. The sensitivity and specificity of the urine dip for predicting renal insufficiency were 69.4% (95% confidence interval [CI] 54.6-81.7%) and 57.8% (95%CI 52.4-63.1%) respectively. The positive predictive value was 19% (95%CI 13.5-25.5%), and the negative predictive value was 93% (95%CI 88.7-96%). The positive likelihood ratio was 1.65 (95%CI 1.32-2.06) and the negative likelihood ratio was 0.53 (95%CI 0.34-0.81).Conclusion: In this cohort of patients with uncontrolled diabetes, the test characteristics of the urine dipstick make it a poor screening tool for renal insufficiency in the ED. [West J Emerg Med. 2011;12(2):250-253.]http://escholarship.org/uc/item/50j700d1Urine DipstickScreeningRenal Insufficiency |
| spellingShingle | Arora, Sanjay Long, Theodore Menchine, Michael Test Characteristics of Urine Dipstick for Identifying Renal Insufficiency in Patients with Diabetes Western Journal of Emergency Medicine Urine Dipstick Screening Renal Insufficiency |
| title | Test Characteristics of Urine Dipstick for Identifying Renal Insufficiency in Patients with Diabetes |
| title_full | Test Characteristics of Urine Dipstick for Identifying Renal Insufficiency in Patients with Diabetes |
| title_fullStr | Test Characteristics of Urine Dipstick for Identifying Renal Insufficiency in Patients with Diabetes |
| title_full_unstemmed | Test Characteristics of Urine Dipstick for Identifying Renal Insufficiency in Patients with Diabetes |
| title_short | Test Characteristics of Urine Dipstick for Identifying Renal Insufficiency in Patients with Diabetes |
| title_sort | test characteristics of urine dipstick for identifying renal insufficiency in patients with diabetes |
| topic | Urine Dipstick Screening Renal Insufficiency |
| url | http://escholarship.org/uc/item/50j700d1 |
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