Screening study of dipstick urinalysis of healthy neonates delivered in tertiary care hospital, from Vadodara, Gujarat

Abstract

Background: Urinary dipstick is one of the most important advances in the current diagnostic procedure in pediatric nephrourology. Dipstick test is easy to perform bedside test, gives an immediate result, is relatively cheap, and require less sophisticated training of personnel; so could be used for asymptomatic patients. Objectives: The objectives of the study were to evaluate the usefulness of urine dipstick bedside screening test for diagnosis of underlying congenital kidney disease in otherwise healthy neonates. Materials and Methods: The study was conducted from April 2018 to November 2018. A total of 900 healthy newborns were enrolled. Random spot urine samples were obtained within first 72 h of life. Dipstick test was performed using Siemens Multistix 10SG and positive or negative reading for biochemical parameters was recorded and compared with laboratory test. Newborns with 1st positive dipstick test were issued screen positive cards and called for follow-up on 7th day of life for 2nd dipstick test. Those with persistent 2nd dipstick positive were further investigated to rule out any congenital anomaly. Results: Of total 900 neonates, 504 (56%) were males and 396 (44%) were females. Of the total newborns, 441 (49%) were positive for proteinuria, 2 (0.2%) for nitrites, and 54 (6%) for leukocytes during 1st dipstick urinalysis. Urine routine microscopic evaluation showed 450 (50%) positive for protein and 322 (35%) positive for pus cells. On subsequent follow-up of positive cases, only 2 (0.5%) newborns were positive for proteinuria on 2nd dipstick (p=0.7061). Conclusion: Bedside dipstick urine test as a screening test was not useful in otherwise healthy neonates due to renal immaturity in first few days of life.