J Vet Sci.  2021 Jan;22(1):e14. 10.4142/jvs.2021.22.e14.

Comparison of three types of analyzers for urine protein-tocreatinine ratios in dogs

Affiliations
  • 1Laboratory of Clinical Pathology, College of Veterinary Medicine, Seoul National University, Seoul 08826, Korea
  • 2BK 21 PLUS Program for Creative Veterinary Science Research, College of Veterinary Medicine, Seoul National University, Seoul, 08826, Korea
  • 3Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University, Seoul, 08826, Korea

Abstract

Background
Quantitation of urine protein is important in dogs with chronic kidney disease.Various analyzers are used to measure urine protein-to-creatinine ratios (UPCR).
Objectives
This study aimed to compare the UPCR obtained by three types of analyzers (automated wet chemistry analyzer, in-house dry chemistry analyzer, and dipstick reading device) and investigate whether the differences could affect clinical decision process.
Methods
Urine samples were collected from 115 dogs. UPCR values were obtained using three analyzers. Bland-Altman and Passing Bablok tests were used to analyze agreement between the UPCR values. Urine samples were classified as normal or proteinuria based on the UPCR values obtained by each analyzer and concordance in the classification evaluated with Cohen's kappa coefficient.
Results
Passing and Bablok regression showed that there were proportional as well as constant difference between UPCR values obtained by a dipstick reading device and those obtained by the other analyzers. The concordance in the classification of proteinuria was very high (κ = 0.82) between the automated wet chemistry analyzer and in-house dry chemistry analyzer, while the dipstick reading device showed moderate concordance with the automated wet chemistry analyzer (κ = 0.52) and in-house dry chemistry analyzer (κ = 0.53).
Conclusions
Although the urine dipstick test is simple and a widely used point-of-care test, our results indicate that UPCR values obtained by the dipstick test are not appropriate for clinical use. Inter-instrumental variability may affect clinical decision process based on UPCR values and should be emphasized in veterinary practice.

Keyword

Dog; creatinine; point-of-care testing; proteinuria; urinalysis
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