We review evidence on the value of dipstick urinalysis screening for hemoglobin and protein in asymptomatic adults. In young adults, evidence from five population-based studies indicates that fewer than 2% of those with a positive heme dipstick have a serious and treatable urinary tract disease, too few to justify screening and the risks of subsequent workup. For older populations, evidence is contradictory and no recommendation can presently be made for or against hematuria screening. A population-based randomized, controlled trial of hematuria screening in the elderly is urgently needed. Proteinuria screening is not recommended in any healthy, asymptomatic adult population, since four population-based studies have found that fewer than 1.5% of those with positive dipsticks have serious and treatable urinary tract disorders.
Woolhandler S, Pels RJ, Bor DH, Himmelstein DU, Lawrence RS. Dipstick Urinalysis Screening of Asymptomatic Adults for Urinary Tract Disorders: I. Hematuria and Proteinuria. JAMA. 1989;262(9):1214–1219. doi:10.1001/jama.1989.03430090076037
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