Prospective evaluation of routine admission urinalyses

M. C. Hermansen and F. M. Blodgett

Nine hundred fifty-four pediatric patients admitted to our hospital had a "dipstick" urinalysis. Glucosuria, hematuria, and proteinuria were found in 6.0%, 5.3%, and 2.5%, respectively. By requiring two urinalyses and by eliminating artifacts that led to false-positive results, these rates declined to 0.9%, 2.2%, and 0.6%. A verbal "prompt" of the house staff was used to achieve a 95% follow-up rate. Four new diagnoses resulted from the effort: juvenile-onset diabetes mellitus, pelvic kidney, sickle cell trait, and asymptomatic bacteriuria. However, it is questionable as to whether any of these patients benefited. In addition, when specific screening criteria are applied, it is difficult to justify a routine screening urinalysis on every pediatric hospital admission. The cost of screening, diagnosis, and treatment was $3,671. Recommendations are given to those undertaking any hospital admission screening effort.