Abstract: PUB370
ECONomical STRIP Validation for CKD Screening: A Cross-Sectional Trial (ECON-STRIP)
Session Information
Category: CKD (Non-Dialysis)
- 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Bunyawannukul, Issaree, Khon Kaen University Faculty of Medicine, Khon Kaen, Thailand
- Anutrakulchai, Sirirat, Khon Kaen University Faculty of Medicine, Khon Kaen, Thailand
- Cha'on, Ubon, Khon Kaen University Faculty of Medicine, Khon Kaen, Thailand
- Ophascharoensuk, Vuddhidej, Chiang Mai University Faculty of Medicine, Chiang Mai, Thailand
- Kaewsanga, Yosapan, Khon Kaen University Faculty of Medicine, Khon Kaen, Thailand
Background
Chronic kidney disease (CKD) represents a significant global public health concern, particularly in low- and middle-income countries, where more than 80% of stage 3 CKD cases remain undiagnosed due to the limited availability of effective screening tools. The urine albumin-to-creatinine ratio (UACR) is the reference standard for detecting albuminuria; however, point-of-care dipstick tests offer a feasible and cost-effective alternative in resource-constrained settings.
Methods
This cross-sectional diagnostic study was conducted at Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand. Random midstream spot urine samples were evaluated using seven testing methods: 1) MicroalbuPHAN® (manual visual strip), 2)
MicroalbuPHAN® with LAURA automated reader, 3) CYBOW 2 (manual visual strip), 4)
CYBOW 2 with automated reader, 5) Thai-developed AL strip using competitive immunochromatography, 6) standard macro-protein dipstick, and 7) UACR measured by the Roche® analyzer (reference standard).
Results
A total of 459 participants were enrolled, with a mean age of 62.42 ± 12.14 years and 52.72% being male. The prevalence of comorbidities included diabetes mellitus (61.44%), hypertension (60.57%), and CKD (34.20%). The mean estimated glomerular filtration rate (eGFR) was 68.52 ± 23.18 mL/min/1.73 m2, and the median UACR was 14.0 (IQR 4.54–80.79) mg/gCr. The lowest cost per test was observed with the macro-albumin strip, while the AL strip had the highest cost. Diagnostic performance for detecting UACR ≥ 30 mg/gCr varied across methods, with the highest receiver operating characteristic (ROC) area observed in strips coupled with automated readers. The strongest correlation with UACR was noted in the MicroalbuPHAN® with LAURA automated reader (r = 0.76), which also offered favorable economic value.
Conclusion
Semi-quantitative urine dipstick tests, especially when used with automated readers, demonstrate diagnostic performance comparable to laboratory-based UACR assessments at a reduced cost. These findings support the utility of such methods in CKD screening programs within resource-limited settings. Further studies incorporating clinical outcomes are recommended to validate their long-term efficacy.