Proteinuria: accuracy and precision of laboratory diagnosis by dip-stick analysis

We studied and compared results of two urine dip-stick procedures for protein with those of quantitative measurements of total protein and albumin in urine. Sensitivity, specificity, and predictive value of "normal" and "abnormal" dip-stick results, assay efficiency, technologist precision, and method association were determined. Precision was poor, attributable largely to variation within each technologist. Relative to a defined measure of precision, technologist performance appears to be uniform within each product. Patients' urinary protein concentrations of less than 200 mg/liter can be distinguished from concentrations greater than 3000 mg/liter with confidence by dip-stick procedures. Urin samples with low albumin/total protein ratios were frequently falsely negative by dip-stick assays.