Comparison of the diagnostic utility of thresholds for dipstick protein and albuminuria at baseline to identify patients with future rapid kidney function decline: Overall and by risk subsets of the population
| n | % | Pretest Probability of RKFD | Screen Positive (%) | False-Positive Rate | LR+/LR− | Posttest probability of RKFD | NNTS | NNTF | |
|---|---|---|---|---|---|---|---|---|---|
| Overall | 2574 | 100% | 0.09 | ||||||
| albuminuriaa | 253 | 9.8 | 8.9 | 3.2 | 0.20 | 10.2 | 5 | ||
| dipstick protein | |||||||||
| ≥trace | 145 | 5.6 | 4.7 | 3.7 | 0.23 | 17.8 | 4.3 | ||
| ≥1 g/L | 63 | 2.5 | 1.7 | 7.2 | 0.38 | 40.9 | 2.6 | ||
| ≥3 g/L | 42 | 1.6 | 1.1 | 7.8 | 0.41 | 61.3 | 2.5 | ||
| No risk factorsb | 1393 | 54% | 0.05 | ||||||
| albuminuriab | 55 | 4 | 3.9 | 1.2 | 0.05 | 25.3 | 18.3 | ||
| dipstick protein | |||||||||
| ≥Trace | 54 | 3.9 | 3.7 | 2.2 | 0.09 | 25.8 | 10.8 | ||
| ≥1 g/L | 15 | 1.1 | 0.9 | 5.4 | 0.20 | 92.9 | 5 | ||
| ≥3 g/L | 11 | 0.8 | 0.7 | 4.7 | 0.18 | 126.6 | 5.5 | ||
| With risk factorsa | 1181 | 46% | 0.13 | ||||||
| albuminuriab | 198 | 16.8 | 14.7 | 2.6 | 0.24 | 6 | 4.1 | ||
| dipstick protein | |||||||||
| ≥Trace | 91 | 7.7 | 6.1 | 3.5 | 0.32 | 13 | 3.1 | ||
| ≥1 g/L | 48 | 4.1 | 2.6 | 5.7 | 0.44 | 24.6 | 2.3 | ||
| ≥3 g/L | 31 | 2.6 | 1.6 | 6.7 | 0.48 | 38.1 | 2.1 | ||
| Diabetes | 366 | 26% | 0.19 | ||||||
| albuminuriab | 107 | 29.2 | 24.5 | 3.1 | 0.32 | 3.4 | 3.1 | ||
| dipstick protein | |||||||||
| ≥Trace | 44 | 12.0 | 8.7 | 3.8 | 0.41 | 8.3 | 2.4 | ||
| ≥1 g/L | 33 | 9.0 | 5.4 | 5.9 | 0.52 | 11.1 | 1.9 | ||
| ≥3 g/L | 21 | 5.7 | 3.4 | 5.6 | 0.52 | 17.4 | 1.9 | ||
| Other risksc | 815 | 59% | 0.11 | ||||||
| albuminuriab | 0 | 11.2 | 10.6 | 1.6 | 0.15 | 9.0 | 6.5 | ||
| dipstick protein | |||||||||
| ≥Trace | 0 | 5.8 | 5.0 | 2.7 | 0.23 | 17.3 | 4.3 | ||
| ≥1 g/L | 0 | 1.8 | 1.5 | 3.0 | 0.27 | 54.3 | 3.8 | ||
| ≥3 g/L | 724 | 1.2 | 0.8 | 5.6 | 0.40 | 81.5 | 2.5 |
LR+/LR−, ratio of positive to negative likelihood ratios; NNTF, number of patients needed to follow with serial serum-creatinine measurements to identify one case of RKFD (the inverse of the prevalence of RKFD among screen positive); NNTS, number of patients needed to screen to identify one positive result (the inverse of the prevalence of a positive screening result); RKFD, rapid kidney function decline (% annual eGFR decline >5%).
aRandom albumin to creatinine ratio >2.0 mg/mmol (17 mg/g for men or >2.8 mg/mmol (25 mg/g) for women).25,26
bAge >60 years, cardiovascular disease, hypertension, or diabetes.
cAge >60 years, cardiovascular disease, or hypertension.