Analysis of Urine Dipstick Analysis for Screening Urinary Abnormalities in Asymptomatic Children

Urine dipstick analysis is a valuable method for detecting asymptomatic kidney issues. Recent studies indicate that the prevalence of urinary abnormalities in asymptomatic schoolchildren ranges from 0.5% to 5.7%. Currently, India lacks a national urine screening protocol.

The researchers investigated urinary abnormalities in children aged 5 to 15 years who presented with non-renal complaints at an outpatient department between June 2022 and June 2023, excluding those with pre-existing renal conditions. They measured blood pressure and recorded anthropometric data, and conducted urine analysis, kidney function tests, and ultrasounds for those with significant dipstick abnormalities.

The study revealed:

A total of 350 children (55.4% boys) participated, with an average age of 8.2 years.
The mean weight and height standard deviation scores were -0.88 and -1.30, respectively.
The dipstick test revealed at least one abnormal finding in 146 children (41.7%), including trace proteinuria in 72 (21%) and significant proteinuria (1+ or more) in 69 (19.7%).
Additionally, 8 children tested positive for urine leucocyte esterase, 5 for nitrite, and 1 for hematuria.
Of the children, 42% presented with febrile illnesses, and among these, 60% had proteinuria, with 32% showing significant proteinuria.
In afebrile children, 25.6% exhibited proteinuria, with 10.8% classified as significant.
Urine cultures were positive in only 2.8% of cases, and 1.4% had sonographic abnormalities.
Notably, 10.3% of the children had elevated blood pressure, with 6.9% in stage 1 hypertension.

The study concluded that over 20% of children had significant dipstick abnormalities, which is higher than the 2.6% observed in healthy schoolchildren in India. Most proteinuria was associated with fever and absent urinary symptoms, along with a low culture positivity rate, suggesting a transient nature that only requires parental reassurance. Hematuria was rare, occurring in only 0.3% of patients.

Source: Meena V, Mahajan A, Mantan M. Urine Dipstick Screening of Children Presenting with Non-Renal Complaints to Outpatient Department of a Tertiary Care Centre. Indian J Pediatr (2025). https://doi.org/10.1007/s12098-025-05491-0

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