The value of random urine specimen albumin measurement in the screening of early diabetic nephropathy

To assess the performance of measurements of urinary albumin concentration (UAC) in a diurnal random urine specimen (RUS) for the screening of diabetic nephropathy (DN), 24h urine specimen and diurnal random urine specimen in 198 patients with type 2 diabetes mellitus (male 102, female 96, age 40-65) were collected. Albumin was measured by immunoturbidimetry. According to 24h urinary albumin excretion rate (24h UAER), the specimens were classified as normoalbuminuria (24h UAER<20 μg/min, n=102), microalbuminuria (24h UAER 20-200 μg/min, n=96). The receiver operating characteristic (ROC) curve approach was used. The ROC curves of UAC in RUS for screening of microalbuminuria were plotted. Spearman's coefficient of correlation of 24h UAER vs UAC was 0.92 (P<0.001). The first point with 100% sensitivity and the point of intersection with a 100% to 100% diagonal for microalbuminuria were as follows: 15 mg/L(74% specificity) and 30 mg/L (92% sensitivity and 89% specificity). Measurement of UAC in RUS presented almost perfect accuracy for the screening of microalbuminuria, and UAC measured in a RUS is simpler than 24h UAER, it is suggested as a valid test for screening of incipient diabetic nephropathy in clinical practice