The value of urine screening in a young adult population

Abstract

Background. GPs in England and Wales are required to perform screening urinalysis on all newly registered patients. The value of this practice, however, is unclear. Objective. The purpose of this study was to identify the prevalence of persistent urine abnormalities and to establish the added value of screening for both haematuria and proteinuria in a large cohort of young adults in the UK. Methods. Urine screening was carried out in a cohort of young adults in a student health centre and a university hospital nephrology unit in a large British city. University students enrolling for health screening in a university health centre over a 2-year period were tested for haematuria and/or proteinuria by dipstick urinalysis. Subjects with persistent urine abnormalities were evaluated for the presence of significant renal tract pathology. Results. Of 3808 students screened, 3570 provided an initial urine sample; 220 were abnormal. Of these, 38 (1% of original cohort) had persistent abnormalities (haematuria, 14; proteinuria, 16; both, eight). Subjects with isolated haematuria or proteinuria did not have significant pathology. In contrast, all the students with both haematuria and proteinuria had identifiable renal disease. Conclusions. Our findings do not support the value of routine screening for proteinuria or haematuria in young adults. However, the combination of haematuria and proteinuria is a powerful predictor for parenchymal renal disease. Thus, if proteinuria is detected, further testing for haematuria should be performed.