The usual screening test is visual dipstick assessment. A two plus
dipstick measurement can be taken
as evidence of proteinuria but ideally a more accurate test (either a
spot protein creatinine ratio or
ideally a 24-hour urine collection) is required to confirm this. While
it has to be acknowledged that there is poor predictive value from urine
dipstick testing,0502
False negative as well as false
positive rates are recorded with the use of visual dipstick
assessment.10?12 Problems can be reduced
by training. An automatic dipstick reader can overcome some of the
observer error found with
urinary dipsticks but these are not routinely available. Newer techniques
such as protein/creatinine
ratios have not been fully evaluated but may be a valid alternative. A
level of 0.03 g/mmol appears
to be equivalent to 0.3 g/24 hours.6 In view of the high false positive
rates with dipsticks,laboratory
testing, usually by 24-hour urine collection, is recommended to confirm
significant proteinuria,
unless the clinical urgency dictates immediate delivery.
