Évaluation du Micral Test® en vue du dépistage de la microalbuminurie en biologie délocalisée

Microalbuminuria (μAlb) is an analysis with strong clinical value for the follow-up of the patient's diabetics or suspects of kidney damage. For the physician the result of this research is crucial for the control of the consultation, the therapeutic decision and the assumption of responsibility of the cardiovascular risk. Point of care testing can provide a good tool for early detection of renal failure patients by using an albumin titrator stick test which is fast and reliable. The threshold of positivity of Micral Test® (MT) proposed by the Roche Company is 20 mg/L, identical to the one of the quantitative method. It was used simultaneously by the nurses and the technicians; 50 samples are analyzed with values of μAlb ranging from 2,5 to 120 mg/L. The agreement of the measurements of the μAlb with the result of the MT performed by the technicians is 94 % versus 64 % for the test performed by the nurses including 8 % of false negative results. In the hands of the technicians, the MT provides results well correlated with the IT method (Spearman test r2 = 0,907) but on a measurement limited range from 0 to 100 mg. On the other hand, the results obtained by the nurses are definitely less favorable (r2 = 0,545). The MT, although simple, must be performed by professionals carefully trained in order to guarantee its accuracy. This test can be the most useful during consultations of diabetology and nephrology when the patient is seen for the very first time.