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Open Access Research article

Prevalence of microalbuminuria and diagnostic value of dipstick proteinuria in outpatients from HIV clinics in Bukavu, the Democratic Republic of Congo

Mannix Imani Masimango126*, Ernest Kiswaya Sumaili1, Michel Jadoul3, Pierre Wallemacq4, Dieudonné Kanigula Mubagwa5, Rissassy Jean-Robert Makulo1, François Bompeka Lepira1 and Nazaire Mangani Nseka1

Author Affiliations

1 Department of Medicine, Université Catholique de Bukavu, Bukavu, DR Congo

2 Nephrology Unit, Department of Medicine, Université de Kinshasa, Kinshasa, DR Congo

3 Department of Nephrology, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium

4 Clinical Chemistry Department, Cliniques Universitaires St Luc, Louvain Center for Toxicology And Applied Pharmacology, Université Catholique de Louvain, Brussels, Belgium

5 Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium

6 Postal address: 103 Cyangugu, Rwanda

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BMC Nephrology 2014, 15:146  doi:10.1186/1471-2369-15-146

Published: 5 September 2014

Abstract

Background

Microalbuminuria is a marker of early kidney disease and high cardiovascular risk in various populations, including HIV positive patients. However, the diagnostic value of qualitative (dipstick) proteinuria and the burden of microalbuminuria in HIV positive patients living in sub-Saharan Africa are relatively unclear.

Methods

In a cross-sectional study, 235 HIV- positive outpatients were screened for proteinuria in 3 HIV-clinics in Bukavu. A spot urine sample from each subject was tested both by a dipstick and albumin-creatinine-ratio (ACR) assay. The performance of dipstick proteinuria exceeding 1+ was compared with that of microalbuminuria (≥30 mg/g creatinine).

Results

The prevalence of microalbuminuria and dipstick proteinuria ≥ (1+), ≥ (2+) and ≥ (3+) was 11%, 41%, 3.5% and 0.7%, respectively.

Compared to microalbuminuria, the dipstick (proteinuria of 1+ or greater) had an overall sensitivity of 60% and a specificity of 61%. The positive predictive value was 15.4% and the negative predictive value 92.8%.

Conclusion

Proteinuria is highly prevalent in HIV positive patients. The limited sensitivity and specificity of the dipstick to detect significant microalbuminuria make it unattractive as a screening tool in HIV positive patients.

Keywords:
Dipstick proteinuria; Albumin/creatinine ratio; Diagnostic value; HIV-patients