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Background: Taiwan has the highest end-stage renal disease prevalence in the world, and the costs on the maintenance of dialysis imposes a great financial burden on National Health Insurance. Routine urinalysis provides an opportunity for the early detection of microalbuminuria. We evaluated the accuracy of semi-quantitative chemical methods from Siemens Novus Pro12 dipstick for albumin-creatinine ratio (ACR)., Methods: We collected 1029 random urine samples and performed urinary analytic tests by Siemens Novus with Pro12 dipsticks and also calculated the urinary ACR. The reference method was performed by Hitachi LST008, a quantitative assay. The percentage of exact agreement in ACR was 81.9% between Siemens Novus and Hitachi LST008. The percentage of agreement within 1 level between the 2 methods was 98.5%. When ACR > 30 mg/g was defined as the threshold for positive results, the sensitivity, specificity, positive, and negative predictive values for microalbuminuria were 87.2%, 91.6%, 91.5%, and 87.3%, respectively. There were 778 cases with negative results of urinary protein, analyzed by conventional dipsticks. 149 of 778 (19.2%) cases were positive, measured by Pro12 dipsticks, and 111 of 149 (74.5%) cases were confirmed positive ACR by Hitachi LST008., Conclusions: Urinary ACR measured by Siemens Novus with Pro12 dipsticks was shown to be a reliable test for detection of microalbuminuria., (Copyright © 2020. Published by Elsevier B.V.)

This study was aimed at revealing the factors and the interrelationships between factors on microalbuminuria development among type 2 diabetes (T2D) patients. Between 2004 and 2011, 461 T2D patients with a baseline urine albumin-to-creatinine ratio (UACR) of <30 mg/g, and an estimated glomerular filtration rate (eGFR) of >60 mL/min were evaluated retrospectively. Sixty-eight (14.8%) subjects had developed microalbuminuria in a mean follow-up of 6.82 years. Statistical analysis had revealed that the higher baseline UACR (10 mg/g; sensitivity, 80.9%, specificity, 63.6%; AUC = 0.774) and glycohemoglobin level (HbA1c) (8%; sensitivity, 72.1%, specificity, 61.6%; AUC = 0.698) were the two independent microalbuminuria risk factors. When considering the risk of microalbuminuria, the data were normalized with respect to subjects with low-normal UACR (<10 mg/g) and HbA1c < 8%. The adjusted hazard ratio for subjects with low-normal UACR/HbA1c > 8%, high-normal UACR/HbA1c < 8%, and high-normal UACR/HbA1c >8% were 2.59 (p = 0.107), 6.15 (p = 0.001), and 16.96 (p < 0.001), respectively. It was determined that an increase of HbA1c levels (<8, 8-9, 9-10, >10%) showed a progressively increase of the hazard risk in baseline high-normal UACR group. But the same correlation was not shown in the low-normal UACR group. This study identified the relationships of high-normal albuminuria and glycemic control on microalbuminuria development among T2D patients. Glycemic control is especially beneficial for T2D patients with baseline high-normal UACR in preventing microalbuminuria development.