Related Experiment Video
Updated: Jul 10, 2026
Low-Cost, Volume-Controlled Dipstick Urinalysis for Home-Testing
Published on: May 8, 2021
Efficacy of urine screening at school: experience in Shanghai, China
Yi-Hui Zhai1, Hong Xu, Guang-Hua Zhu
1Department of Nephrology, Children's Hospital of Fudan University, Shanghai, People's Republic of China. hxu@shmu.edu.cn
Insights
School urine screening for hematuria and proteinuria in over 40,000 children found a 5% abnormality rate. Repeating manual dipstick tests (method A) twice is economical and effective for detecting kidney disease.
Area of Science:
- Pediatric Nephrology
- Public Health Screening
Background:
- Asymptomatic chronic renal diseases in children pose a significant health concern.
- Effective screening methods are crucial for early detection and intervention.
Purpose of the Study:
- To determine the prevalence of hematuria and proteinuria in Shanghai school children.
- To evaluate the efficacy and cost-effectiveness of different urine screening methods.
Main Methods:
- Urine screening of over 40,000 school children (2003-2005) using manual dipsticks (method A) or machine-read dipsticks (method B).
- Sulfosalicylic acid test and microscopy were used as confirmatory tests.
- Children with abnormal results underwent a second screening 2 weeks later.
Main Results:
- Initial screening revealed a >5% prevalence of urine abnormalities, decreasing to ~1% on second screening.
- Method B and two-sample testing demonstrated higher specificity.
- Screening twice with method A was more cost-effective than a single method B screen, reducing false positives.
Conclusions:
- School urine screening can detect asymptomatic chronic kidney diseases in children.
- A twice-repeated manual dipstick test (method A) is recommended as a convenient, economical, and effective screening strategy for Shanghai school children.
Abstract:
To explore the prevalence of hematuria or proteinuria in school children in Shanghai and to evaluate the screening methods, we conducted urine screening in more than 40,000 school children between 2003 and 2005. Children were tested with dipsticks read manually (method A) or dipsticks read by machines (method B) combined with a sulfosalicylic acid test or microscopy. Some children were tested once, and others who had abnormal results in the first screening were tested again 2 weeks later. The prevalence of urine abnormalities in the first screening was more than 5.00% and of the second screening about 1.00%. Either method B or testing two urine samples for each child had higher specificity. As to the direct cost, that of screening twice with method A was lower than just screening once with method B. So using method A to screen twice for each child was not only convenient and economical, but also could reduce the false positive rate effectively. More than 10 months of follow-up diagnosed two cases of IgA nephropathy. Asymptomatic chronic renal diseases in school children could be detected through school urine screening. For Shanghai, China, screening twice using method A might be the best choice.
Related Concept Videos
01:29Urine Studies I: Urinalysis
01:26Urine Studies II: Urine Culture and Sensitivity Test