We appreciate the opportunity to clarify aspects of our editorial in response to the comments of White et al.1 In our editorial,2 the 16.9% rate of “dipstick proteinuria” referred to the result reported by White et al.3 In their study they found urine dipstick readings of “negative, trace, or ≥1+ result in 83.1%, 8%, and 8.1% of participants, respectively,” indicating that either 16.9% or 16.1% had proteinuria detected by dipstick (ie, 100% – 83.1% = 16.9% or 8% + 8.1% = 16.1%). When assessed by albumin-creatinine ratio (ACR), the proportion with proteinuria is comparable to other studies (Table 1) but prevalences given for the 2 dipstick reading categories of ≥1+ and trace or higher are substantially greater than those found in most other studies [4], [5] and [6] (8.1% vs 1%-3% and 16.1% vs 8%-9%, respectively). We have found urine dipstick protein results of trace or higher to be of value in screening for ACR ≥ 30 mg/g and were surprised by the large difference found by White et al in the proportion of participants with ACR ≥ 30 mg/g (6.6%) and those with a dipstick reading of trace or higher (16.1%). In our Taiwanese study, the prevalence of dipstick readings or trace or higher (7.9%) approximated the proportion with ACR ≥ 30 mg/g (6.9%). [3] and [4] In pooled studies by the Chronic Kidney Disease Prognosis Consortium (CKD-PC) of 1.1 million individuals,5 dipstick proteinuria ≥ 1+ was found in 3.3% (2.3% + 1.0% = 3.3%); in the Taiwan study, this value was 1.7% (0.9% + 0.8% = 1.7%; Table 1). Thus, in our opinion, the proportion with dipstick proteinuria ≥ 1+ in the study from White et al (8.1%) is higher than expected.
日期:
2011-12
關聯:
American Journal of Kidney Diseases. 2011 Dec;58(6):1039-1040.
