Background: Tubular dysfunction is common in HIV-infected people and detection of proteinuria is essential to\nidentify this problem. In low-income countries, resources for detection of proteinuria using the Kidney Disease\nImprove Global Outcomes (KDIGO) gold standard urinary protein/creatinine ratio (uPCR) is rarely possible, and\nuse of the protein reagent strip (PRS) could be an option in these places. The aims of this study were to establish\nthe concordance between PRS and uPCR to detect tubular proteinuria in HIV-infected people, and to assess the\nsensitivity and specificity of PRS as a diagnostic method in this group.\nMethods: A cross-sectional study was conducted to evaluate the correlation between the two techniques to detect\nprotein in urine. Participants were enrolled for a period of 6 months. The measurements were performed in participants\nwho were on highly active antiretroviral therapy (HAART) or prior to the start of treatment. Proteinuria was defined as\nuPCR ? 150 mg/g, and/or ? trace on PRS. A phi coefficient was calculated to establish the degree of correlation. We\nassessed the sensitivity and specificity of PRS compared with uPCR using standard methods.\nResults: A total of 799 subjects were included. Of these, 737 (92%) were men. The mean age was 32.9 years\n(Ã?±10.1 years). Most (561, 70%) were on antiretroviral treatment. The mean estimated glomerular filtration rate (eGFR)\ncalculated according to Modification of Diet in Renal Disease (MDRD)-4 was 113.0 mL/min (Ã?±22.6). Comorbidities\nincluded diabetes mellitus (10, 1.3%) and hypertension (17, 2.1%). The prevalence of proteinuria detected by PRS was\n8.3% (n = 66) and by uPCR 10.6% (n = 85). The concordance assessed by phi correlation coefficient was 0.70, p < 0.001,\nwith a sensitivity of 51.7% (95% confidence interval [CI] 41%ââ?¬â??62%) and specificity 97% (95% CI 39%ââ?¬â??97%).\nConclusions: There is a high concordance between detection of proteinuria by PRS and uPCR. Therefore, in\nlow-income countries PRS can be helpful for detecting tubular damage in people infected with HIV.
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