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Article

Albuminuria Is Affected by Urinary Tract Infection: A Comparison between Biochemical Quantitative Method and Automatic Urine Chemistry Analyzer UC-3500

1
Division of Urology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei 23142, Taiwan
2
Department of General Laboratory, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei 23142, Taiwan
3
Department of Urology, National Taiwan University Hospital, Taipei 10002, Taiwan
4
School of Medicine, Tzu Chi University, Hualien 97004, Taiwan
*
Author to whom correspondence should be addressed.
Diagnostics 2023, 13(21), 3366; https://doi.org/10.3390/diagnostics13213366
Submission received: 7 September 2023 / Revised: 13 October 2023 / Accepted: 24 October 2023 / Published: 2 November 2023
(This article belongs to the Special Issue Advances in the Diagnosis and Management of Kidney Diseases)

Abstract

The automated urine reagent strip test is a cost-effective tool for detecting albuminuria in patients. However, prior research has not investigated how urinary tract infections (UTIs) affect the test’s accuracy. Therefore, this study aims to assess the impact of UTIs on albuminuria diagnosis using both the biochemical quantitative method and the test strip method of the Fully Automatic Urine Chemistry Analyzer, UC-3500 (Sysmex, Kobe, Japan). From March to December 2019, we prospectively collected midstream urine from adult female UTI patients before and after one week of cephalexin treatment. The urine samples were subjected to culture, routine urinalysis, and albuminuria diagnosis using the biochemical quantitative method and UC-3500. Albuminuria was defined as a urine albumin to creatinine ratio (UACR) ≥ 30 mg/g in the biochemical quantitative method. The results were compared between the two methods. Among fifty-four female patients (average age: 50.5 ± 4.4 years) with UTIs, 24 (44.44%) had transient albuminuria. The quantitative UACR significantly decreased after one week of antibiotic treatment (median: 53 mg/g to 9 mg/g; median difference: −0.54, p < 0.0001). UC-3500 exhibited a higher false positive rate for diagnosing albuminuria during UTIs (42%) compared to after treatment (19%). Its agreement with the biochemical quantitative method was moderate during UTI (κ = 0.49, 95% confidence interval [CI]: 0.24–0.73) and good after treatment (κ = 0.65, 95% CI: 0.45–0.86). UC-3500’s accuracy in diagnosing albuminuria is influenced by UTIs, leading to either transient albuminuria or a false positive reaction of the test strip. UTI should be excluded or treated before its application in albuminuria screening.
Keywords: albuminuria; diagnosis; automation laboratory; urinary tract infection albuminuria; diagnosis; automation laboratory; urinary tract infection

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MDPI and ACS Style

Chou, Y.-J.; Yang, C.-C.; Chang, S.-J.; Yang, S.S.-D. Albuminuria Is Affected by Urinary Tract Infection: A Comparison between Biochemical Quantitative Method and Automatic Urine Chemistry Analyzer UC-3500. Diagnostics 2023, 13, 3366. https://doi.org/10.3390/diagnostics13213366

AMA Style

Chou Y-J, Yang C-C, Chang S-J, Yang SS-D. Albuminuria Is Affected by Urinary Tract Infection: A Comparison between Biochemical Quantitative Method and Automatic Urine Chemistry Analyzer UC-3500. Diagnostics. 2023; 13(21):3366. https://doi.org/10.3390/diagnostics13213366

Chicago/Turabian Style

Chou, Yi-Ju, Chun-Chun Yang, Shang-Jen Chang, and Stephen Shei-Dei Yang. 2023. "Albuminuria Is Affected by Urinary Tract Infection: A Comparison between Biochemical Quantitative Method and Automatic Urine Chemistry Analyzer UC-3500" Diagnostics 13, no. 21: 3366. https://doi.org/10.3390/diagnostics13213366

APA Style

Chou, Y.-J., Yang, C.-C., Chang, S.-J., & Yang, S. S.-D. (2023). Albuminuria Is Affected by Urinary Tract Infection: A Comparison between Biochemical Quantitative Method and Automatic Urine Chemistry Analyzer UC-3500. Diagnostics, 13(21), 3366. https://doi.org/10.3390/diagnostics13213366

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