Search tips
Search criteria 


Logo of brjgenpracRCGP homepageJ R Coll Gen Pract at PubMed CentralBJGP at RCGPBJGP at RCGP
Br J Gen Pract. 1995 February; 45(391): 71–73.
PMCID: PMC1239138

Danish general practitioners' estimation of urinary albumin concentration in the detection of proteinuria and microalbuminuria.


BACKGROUND. Microalbuminuria may predict proteinuria and increased mortality in non-insulin dependent diabetic patients. Early detection of microalbuminuria may therefore be essential. AIM. The primary objective of this study was to describe the association between the presence of albuminuria in diabetic patients as detected by general practitioners using conventional reagent strip dipstick tests for albumin, and the urinary albumin concentration as measured in a hospital laboratory. METHOD. A total of 675 newly diagnosed diabetic patients aged 40 years or over were included in the Danish study, diabetes care in general practice. Data for urinary albumin concentration from a morning urine sample and the results of three consecutive dipstick tests for albumin were collected for 417 patients. RESULTS. When defining elevated urinary albumin concentration as 200 mg l-1 or more (proteinuria) the finding of at least one positive test out of the three dipstick tests for albumin had a diagnostic sensitivity of 73% and a specificity of 89%. When the microalbuminuric range (15.0 to 199.9 mg l-1) was added to the definition of renal involvement, the sensitivity of the dipstick test became as low as 28% with a specificity of 96%. CONCLUSION. It is essential for general practitioners to be able to identify proteinuric patients. To achieve this by means of the conventional dipstick test, general practice procedures need to be improved. As it is becoming increasingly well-documented that microalbuminuric non-insulin dependent diabetic patients may benefit from pharmacological treatment of even slight arterial hypertension and heart failure, it seems reasonable to suggest that the use of dipsticks for albumin in general practice be replaced by laboratory quantitative determination of urinary albumin concentration in a morning urine sample.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (630K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Olivarius ND, Lauritzen T, Beck-Nielsen H, Fog J, Mogensen CE. Co-ordination of diabetes care in the primary and the secondary health care system in Denmark. Danish National Board of Health. Diabet Med. 1994 Jan-Feb;11(1):123–125. [PubMed]
  • Uusitupa M, Siitonen O, Penttilä I, Aro A, Pyörälä K. Proteinuria in newly diagnosed type II diabetic patients. Diabetes Care. 1987 Mar-Apr;10(2):191–194. [PubMed]
  • Olivarius N de F, Andreasen AH, Keiding N, Mogensen CE. Epidemiology of renal involvement in newly-diagnosed middle-aged and elderly diabetic patients. Cross-sectional data from the population-based study "Diabetes Care in General Practice", Denmark. Diabetologia. 1993 Oct;36(10):1007–1016. [PubMed]
  • Mogensen CE. Microalbuminuria predicts clinical proteinuria and early mortality in maturity-onset diabetes. N Engl J Med. 1984 Feb 9;310(6):356–360. [PubMed]
  • Schmitz A, Vaeth M. Microalbuminuria: a major risk factor in non-insulin-dependent diabetes. A 10-year follow-up study of 503 patients. Diabet Med. 1988 Mar;5(2):126–134. [PubMed]
  • Neil A, Hawkins M, Potok M, Thorogood M, Cohen D, Mann J. A prospective population-based study of microalbuminuria as a predictor of mortality in NIDDM. Diabetes Care. 1993 Jul;16(7):996–1003. [PubMed]
  • de Fine Olivarius N, Pedersen PA. The Danish Study Diabetes Care in General Practice. Management of main methodological and practical problems in a long-term multipractice intervention study. Scand J Prim Health Care Suppl. 1993;2:49–53. [PubMed]
  • Rowe DJ, Dawnay A, Watts GF. Microalbuminuria in diabetes mellitus: review and recommendations for the measurement of albumin in urine. Ann Clin Biochem. 1990 Jul;27(Pt 4):297–312. [PubMed]
  • Jarrett RJ, Viberti GC, Argyropoulos A, Hill RD, Mahmud U, Murrells TJ. Microalbuminuria predicts mortality in non-insulin-dependent diabetics. Diabet Med. 1984 May;1(1):17–19. [PubMed]
  • Ballard DJ, Humphrey LL, Melton LJ, 3rd, Frohnert PP, Chu PC, O'Fallon WM, Palumbo PJ. Epidemiology of persistent proteinuria in type II diabetes mellitus. Population-based study in Rochester, Minnesota. Diabetes. 1988 Apr;37(4):405–412. [PubMed]
  • Damsgaard EM, Frøland A, Jørgensen OD, Mogensen CE. Eight to nine year mortality in known non-insulin dependent diabetics and controls. Kidney Int. 1992 Apr;41(4):731–735. [PubMed]
  • Ravid M, Savin H, Jutrin I, Bental T, Katz B, Lishner M. Long-term stabilizing effect of angiotensin-converting enzyme inhibition on plasma creatinine and on proteinuria in normotensive type II diabetic patients. Ann Intern Med. 1993 Apr 15;118(8):577–581. [PubMed]
  • Poulsen PL, Hansen B, Amby T, Terkelsen T, Mogensen CE. Evaluation of a dipstick test for microalbuminuria in three different clinical settings, including the correlation with urinary albumin excretion rate. Diabete Metab. 1992 Sep-Oct;18(5):395–400. [PubMed]
  • Marshall SM, Shearing PA, Alberti KG. Micral-test strips evaluated for screening for albuminuria. Clin Chem. 1992 Apr;38(4):588–591. [PubMed]

Articles from The British Journal of General Practice are provided here courtesy of Royal College of General Practitioners