Table 3.
Diagnostic test characteristics of GFR <60 ml/min per 1.73 m2 and abnormal albumin-creatinine ratio for identifying metabolic abnormalities
| Characteristics | Metabolic abnormalities |
|||||
|---|---|---|---|---|---|---|
| ≥1 | potassium ≥5.0 mmol/l | hemoglobin <11 g/dl | bicarbonate <20 mmol/l | phosphorus > 4.6 mg/dl | PTH > 70 pg/ml | |
| GFR <60 | ||||||
| Sensitivity | 0.13 (0.10, 0.16) | 0.31 (0.16, 0.45) | 0.20 (0.10, 0.29) | 0.04 (0.02, 0.06) | 0.09 (0.05, 0.13) | 0.17 (0.13, 0.21) |
| Specificity | 0.96 (0.94, 0.97) | 0.95 (0.93, 0.96) | 0.94 (0.93, 0.96) | 0.94 (0.93, 0.96) | 0.95 (0.93, 0.96) | 0.95 (0.94, 0.97) |
| PPV | 0.34 (0.26, 0.42) | 0.05 (0.03, 0.07) | 0.03 (0.01, 0.04) | 0.01 (0.00, 0.02) | 0.09 (0.05, 0.14) | 0.24 (0.17, 0.31) |
| NPV | 0.86 (0.84, 0.88) | 0.99 (0.99, 1.00) | 0.99 (0.99, 1.00) | 0.99 (0.98, 0.99) | 0.94 (0.93, 0.95) | 0.93 (0.91, 0.95) |
| ACR ≥20 M/30 F | ||||||
| Sensitivity | 0.13 (0.09, 0.17) | 0.11 (0.03, 0.19) | 0.17 (0.08, 0.26) | 0.07 (−0.04, 0.19) | 0.11 (0.03, 0.19) | 0.16 (0.11, 0.20) |
| Specificity | 0.92 (0.90, 0.93) | 0.91 (0.89, 0.92) | 0.91 (0.89, 0.92) | 0.91 (0.89, 0.93) | 0.91 (0.89, 0.92) | 0.91 (0.90, 0.93) |
| PPV | 0.24 (0.18, 0.30) | 0.01 (0.00, 0.02) | 0.02 (0.01, 0.03) | 0.01 (−0.01, 0.03) | 0.08 (0.03, 0.13) | 0.15 (0.11, 0.20) |
| NPV | 0.86 (0.84, 0.88) | 0.99 (0.99, 1.00) | 0.99 (0.99, 1.00) | 0.99 (0.98, 1.00) | 0.94 (0.93, 0.96) | 0.93 (0.91, 0.94) |
| GFR <60 or ACR ≥20 M/30 F | ||||||
| Sensitivity | 0.21 (0.16, 0.26) | 0.30 (0.14, 0.47) | 0.25 (0.14, 0.36) | 0.10 (−0.02, 0.21) | 0.17 (0.08, 0.26) | 0.25 (0.20, 0.30) |
| Specificity | 0.88 (0.86, 0.90) | 0.87 (0.85, 0.89) | 0.87 (0.85, 0.89) | 0.87 (0.84, 0.89) | 0.87 (0.85, 0.89) | 0.88 (0.86, 0.90) |
| PPV | 0.31 (0.23, 0.39) | 0.04 (0.02, 0.06) | 0.02 (0.01, 0.04) | 0.01 (0.00, 0.02) | 0.08 (0.04, 0.13) | 0.22 (0.15, 0.28) |
| NPV | 0.79 (0.77, 0.82) | 0.91 (0.89, 0.93) | 0.91 (0.89, 0.93) | 0.91 (0.89, 0.92) | 0.87 (0.85, 0.88) | 0.85 (0.84, 0.87) |
ACR = Urinary albumin-creatinine ratio (mg/dl); GFR = glomerular filtration rate (ml/min per 1.73 m2); NPV = negative predictive value; PPV = positive predictive value; PTH = parathyroid hormone; 20 M/30 F, ACR 20 mg/dl in males, 30 in females. Values are percentages (95% CIs).