Screening UA should be based on specific conditions

The office screening dipstick urinalysis (UA) is simple to perform,inexpensive and almost universally employed in the well-child care continuum.

The Preventive Pediatric Health Care Recommendations from the AAP Committee on Practice and Ambulatory Medicine(

) include a screening UA in all healthy children at age 5 years. Despite its endurance as a core office test, there are equally long-standing, persuasive data that dispute the UA's clinical and cost-effectiveness when used for routine mass screening.

The following conveys the consensus of AAP Section on Nephrology executive committee members regarding the effective utilization of this old friend.

At the heart of the debate is a shortcoming shared with many screening tests: imperfect sensitivities and specificities that are tremendously magnified when the prevalence of a condition in the general population is small.

To illustrate the point, consider routine testing of children for asymptomatic microscopic hematuria...