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.