Screening for Nephropathy in Diabetes Mellitus: Is Micral-Test Valid among All Diabetics?

Abstract EN

Background.

Using Micral-test (MT) for screening microalbuminuria (MA) among type 2 diabetics (T2D) is helpful.

We aimed at determining prevalence of MA and at describing the MT validity.

Methods.

We studied 182 T2D followed up in family medicine.

Two 24-hour urinary quantitative assays of MA had been used as a gold standard.

Results.

Prevalence of MA was 23%, CI 95%: 16.9–29.1.

MT validity was 77% for sensitivity, 88% for negative predictive value, and 0.2 for Kappa coefficient (p=0.001).

Among subjects having a blood pressure ≥130/80 mmHg, having a CHT/HDL ratio ≥ 3, being a T2D for more than 5 years, and being women, negative predictive values were, respectively, 91%, 89%, 95%, and 91%.

The area under the ROC curve was 0.81 in men (p=0.008) and 0.80 when diabetes duration exceeds 5 years (p=0.001).

The MA value at 100% Sp for MT was 35 mg/L.

Conclusion.

The use of MT in primary healthcare for yearly screening for MA in T2D must be accentuated especially when diabetes duration exceeds 5 years or when associated with other cardiovascular risks.