Assessment of proteinuria by urine dipstick as a predictive marker for dengue hemorrhagic fever in pediatric patients

Abstract

Objective: To investigate whether urinary dipstick proteinuria or urine protein creatinine ratio (UPCR) could predict leakage in children with dengue virus infection.

Methods: This was a prospective cross-sectional study. A total of 141 hospitalized patients with confirmed dengue virus infection were enrolled from three hospitals in Thailand. Once daily, complete blood count, serum albumin, and random morning urine dipstick protein were collected from the day of admission to the day after defervescence. Morning UPCR was only measured in patients from one hospital due to logistic reasons.

Results: There were 81 and 60 patients in the dengue fever (DF) and DHF groups, respectively. The proportion of patients with proteinuria detected using urine dipstick in the DHF group was higher than that in the DF group from Day-1 (one day before defervescence) to Day +1 (one day after defervescence). Urine dipstick for proteinuria of ≥1+ had sensitivity and specificity of 12.8% and 94.4% on Day-1, and 18.9% and 98.6% on Day 0 (the day of defervescence) to differentiate DHF from DF. For UPCR, cut-off values of approximately 0.2 g/g from Day-2 to Day+1 yielded a sensitivity of 71.6%-94.4% and a specificity of 55.6%-100% in differentiating between DF and DHF.

Conclusions: Dipstick proteinuria of ≥1+ on Day-1 to Day+1 after defervescence had poor sensitivity but good specificity in differentiating DHF from DF. UPCR performed better but was less convenient and more expensive than urine dipsticks.

Keywords

Dengue / Pediatric / Proteinuria / Urine dipstick / Urine protein creatinine ratio

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