Is it time to replace 24-hour urinary albumin excretion (UAE) assessment in Trinidad and Tobago

ABSTRACT

OBJECTIVE The aim of this study is to compare albuminuria measured by conventional 24-hour urine collection and by spot urine albumin and by determining ACR, in a spot sample of urine. METHODS: A first morning spot sample and 24 hour urine samples were collected from 64 subjects, irrespective of the prevailing pathology. The urinary albumin and creatinine in both the spot and 24 hour urine samples was analyzed using the fully automated chemistry analyzer. RESULTS: Of the 64 participants studied the 24 hour albumin varied from 30-3000 gm, the interquartile range 450-2814 mg. The sensitivity and specificity of the spot urine sample was 81.3% (95% CI 70.9-91.7) and 83.3% (95% CI 76.6-92). CONCLUSION: ACR did not provide any advantage over microalbumin measurement alone and in fact there was satisfactory agreement between the two measurements. ACR in addition requires a higher laboratory effort therefore in a low resource setting microalbumin measurement alone is the more convenient screening method in routine clininical practice especially in the developing world.