Benefit of urinalysis

Objective In the pilot Iran school screening programme, the minimal cost of screening dipstick urinalysis in 1601 asymptomatic school children was determined. Methods The cost of screening dipstick urinalysis was calculated by reviewing the literature for the prevalence of asymptomatic proteinuria, hematuria, bacteriuria, and glucosuria determined by an initial dipstick urinalysis. The minimal cost utilizing data of 3 general physicians was calculated. Costs were determined by using current charge for supplies ordered to perform tests, charges for tests performed by a commercial laboratory, and the cost of a final evaluation by a pediatric nephrologist. Results 4.7% (76/1601) of patients were calculated to have an initial abnormal urinalysis. Upon retesting 1.37% (22/1601) of patients were calculated to have a persistent abnormality. The calculated cost was 167$ to initially screen all 1601pateints with a dipstick urinalysis or 0.092$ per patient. The calculated cost to evaluates the 22 patients with any persistent abnormality on repeat dipstick urinalysis was 0.02$ or 0.001$ per patient. This is the calculated cost for a single screening of 1601 asymptomatic pediatric patients. Conclusion Multiple screening dipstick urinalysis in asymptomatic pediatric is costly and should be discontinued. We propose that a single screening dipstick urinalysis be obtained at school entry age, between 6 and 7 years, in all asymptomatic children.