Prevalence of microalbuminuria and diagnostic value of dipstick proteinuria in outpatients from HIV clinics in Bukavu, the Democratic Republic of Congo
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
BMC Nephrology 2014, 15:146 doi:10.1186/1471-2369-15-146Published: 5 September 2014
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.
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).
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%.
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.