Table 3.

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 RKFDScreen Positive (%)False-Positive RateLR+/LR−Posttest probability of RKFDNNTSNNTF
Overall2574100%0.09
    albuminuriaa2539.88.93.20.2010.25
    dipstick protein
        ≥trace1455.64.73.70.2317.84.3
        ≥1 g/L632.51.77.20.3840.92.6
        ≥3 g/L421.61.17.80.4161.32.5
No risk factorsb139354%0.05
    albuminuriab5543.91.20.0525.318.3
    dipstick protein
        ≥Trace543.93.72.20.0925.810.8
        ≥1 g/L151.10.95.40.2092.95
        ≥3 g/L110.80.74.70.18126.65.5
With risk factorsa118146%0.13
    albuminuriab19816.814.72.60.2464.1
    dipstick protein
        ≥Trace917.76.13.50.32133.1
        ≥1 g/L484.12.65.70.4424.62.3
        ≥3 g/L312.61.66.70.4838.12.1
Diabetes36626%0.19
    albuminuriab10729.224.53.10.323.43.1
    dipstick protein
        ≥Trace4412.08.73.80.418.32.4
        ≥1 g/L339.05.45.90.5211.11.9
        ≥3 g/L215.73.45.60.5217.41.9
Other risksc81559%0.11
    albuminuriab011.210.61.60.159.06.5
    dipstick protein
        ≥Trace05.85.02.70.2317.34.3
        ≥1 g/L01.81.53.00.2754.33.8
        ≥3 g/L7241.20.85.60.4081.52.5
  • 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.