{"pk":17999,"title":"Test Characteristics of Urine Dipstick for Identifying Renal Insufficiency in Patients with Diabetes","subtitle":null,"abstract":"Objective: To evaluate the test characteristics of the urine dipstick as a screening tool for elevated serum creatinine in patients with uncontrolled diabetes mellitus in the emergency department (ED).\n\n\nMethods: Patients with diabetes over the age of 18 who presented to the ED for any complaint over a three-month study period were considered eligible for participation in this study. A finger-stick blood glucose of ≥250 mg/dL at triage was used to confirm the diagnosis of uncontrolled diabetes. After obtaining written consent, each patient had a urine dip performed and a chemistry panel drawn. Any level of proteinuria on the urine dip was considered to be a positive test. Based on the laboratory and clinical guidelines at our institution, renal insufficiency was defined as creatinine concentration of greater than 1.3 mg/dL.\n\n\nResults: Three Hundred ninety-three confirmed patients with uncontrolled diabetes were enrolled in this study, and 49 of these (12.5%) were found to have renal insufficiency. The sensitivity and specificity of the urine dip for predicting renal insufficiency were 69.4% (95% confidence interval [CI] 54.6-81.7%) and 57.8% (95%CI 52.4-63.1%) respectively. The positive predictive value was 19% (95%CI 13.5-25.5%), and the negative predictive value was 93% (95%CI 88.7-96%). The positive likelihood ratio was 1.65 (95%CI 1.32-2.06) and the negative likelihood ratio was 0.53 (95%CI 0.34-0.81).\n\n\nConclusion: In this cohort of patients with uncontrolled diabetes, the test characteristics of the urine dipstick make it a poor screening tool for renal insufficiency in the ED. [West J Emerg Med. 2011;12(2):250-253.]","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial  4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"Urine Dipstick"},{"word":"screening"},{"word":"Renal Insufficiency"},{"word":"Emergency Medicine"}],"section":"Clinical Practice","is_remote":true,"remote_url":"https://escholarship.org/uc/item/50j700d1","frozenauthors":[{"first_name":"Sanjay","middle_name":"","last_name":"Arora","name_suffix":"","institution":"University of Southern California, Keck School of Medicine, Los Angeles, CA","department":"None"},{"first_name":"Theodore","middle_name":"","last_name":"Long","name_suffix":"","institution":"University of Southern California, Keck School of Medicine, Los Angeles, CA","department":"None"},{"first_name":"Michael","middle_name":"","last_name":"Menchine","name_suffix":"","institution":"University of Southern California, Keck School of Medicine, Los Angeles, CA","department":"None"}],"date_submitted":"2010-02-23T08:00:00Z","date_accepted":"2010-02-23T08:00:00Z","date_published":"2011-03-23T07:00:00Z","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/17999/galley/9185/download/"}]}