Routine urinalysis in renal transplant patients

The performance of two commercially available urine dipstick tests was evaluated to exclude significant bacteriuria in midstream urine samples from patients attending a renal transplant outpatient clinic. The use of dipsticks to reduce the necessity for routine microscopy and culture was also assessed. Consecutive urine samples (n = 497) from 121 patients were examined for leucocytes, nitrite, and blood with Multistix* 10SG (Ames) and Nephur test (Boehring) dipsticks. All urine samples also underwent routine microscopy and culture. The sensitivities of the Nephur test and Multistix were 83% and 82%, respectively; the specificities were 28% and 40%, respectively; the negative predictive values were 85% and 88%, respectively; and the positive predictive values were 24% and 29%, respectively. Underlying conditions and treatments in renal patients may have led to relatively low sensitivity and positive predictive values. Traditional microscopy and culture methods are more reliable for renal transplant recipients.