Evaluation of Validity of the Urine Dipstick Test for Identification of Reduced Glomerular Filtration Rate in Japanese Male Workers Aged 40 Years and Over

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  • Kawashima Masatoshi
    Department of Occupational Health, Graduate School of Medical Sciences, Kitasato University
  • Wada Koji
    Department of Public Health, Kitasato University School of Medicine
  • Ohta Hiroshi
    Department of Public Health, Kitasato University School of Medicine
  • Moriya Rika
    Department of Nephrology, Kitasato University Hospital
  • Aizawa Yoshiharu
    Department of Occupational Health, Graduate School of Medical Sciences, Kitasato University

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Objectives: We evaluated the validity of the urine dipstick test for identifying reduced glomerular filtration rate (GFR) in male workers. Methods: This study was conducted in male workers aged ≥ 40 yr. Reduced GFR was categorized as either estimated GFR (eGFR) < 60 ml/min/1.73 m2 (eGFR <60) or eGFR < 50 ml/min/1.73 m2 (eGFR < 50). Four sets of criteria were used to evaluate the GFR on the basis of proteinuria excretion, as measured using the urine dipstick test. Receiver operating characteristic curves were created based on the sensitivity and specificity and used to calculate the area under the curve (AUC) and the 95% confidence intervals (CI). Results: A total of 5,799 workers were included in this study. Use of an abnormal proteinuria criterion of 1+–3+ and a reduced GFR criterion of eGFR < 60 resulted in a sensitivity and specificity of 7.8% and 97.4%, respectively, while a reduced GFR criterion of eGFR < 50 resulted in a sensitivity and specificity of 37.8% and 97.4%, respectively. The AUC was 0.52 (95% CI, 0.48–0.55) for eGFR < 60 and 0.70 (95% CI, 0.59–0.80) for eGFR < 50. Conclusions: In this study, 92.2% of participants with an eGFR < 60 and 62.2% of participants with an eGFR < 50 were overlooked in the urine dipstick test. These results suggest that the urine dipstick test only is not sufficient enough to identify reduced GFR and that both a urine dipstick test and other measures of GFR are required to reliably identify reduced GFR.

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