Risk factors and predictive models about false-negative urine dipstick results in albuminuria patients: population-based study from Korea National Health and Nutrition Examination Survey 2019 to 2022.

Background: Chronic kidney disease prognosis is determined based on glomerular filtration rate and albuminuria categories. However, the albumin-to-creatinine ratio (ACR) test is not performed on all patients as a screening test. The purpose of this study was to identify risk factors for patients with albuminuria confirmed by a urine dipstick negative and develop a model to predict underestimated patients.

Methods: We analyzed data from 19,034 adult patients with a urine dipstick negative from the 2019- 2022 Korea National Health and Nutrition Examination Survey. The risk factor of albuminuria was analyzed by comparing patients with albuminuria with a urine dipstick negative with patients without albuminuria.

Results: A total of 753 patients were identified as having albuminuria with a negative urine dipstick. The results of examinations that can be evaluated at the primary care site, such as sex, age, height, weight, body mass index, abdominal circumference, and blood pressure, were significant. Chronic diseases such as hypertension, diabetes mellitus, and dyslipidemia also showed significant differences. A prediction model was built using the additive score system for factors that showed significant differences, and it was confirmed that the logistic regression and score models had high agreement.

Conclusion: We classified the ACR high-risk group by checking the medical history and physical measurement values that can be performed in the primary examination and applied the blood pressure value to the score model along with self-diagnosis items. In the long term, this model is expected to aid in the cost-effective management of CKD through selective ACR testing.