To evaluate the frequency of abnormal urine routine examination (RE) in order to justify the clinician's frequent requests and use of test either as diagnostic aid to confirm provisional clinical diagnosis or a tool for accidental diagnosis.
Material and Methods
A total of 2000 urine samples received from 1st Sept 2008 to 10th May 2009 were processed in Raazi Diagnostics Pathology Laboratory, Rawalpindi. They were examined for proteins, glucose and blood using Combur-10 urine test strips (Roche) and leucocytes using light microscope. The tests with one or more above mentioned abnormal findings were labeled as Positive.
Out of 2000 samples, 39.8% showed positive results. Pyuria was seen in 25.8%, glycosuria in 7.8%, proteinuria in 7.1% and hematuria in18.35% cases. Tests with positive physicochemical findings were 26.2% and tests with both leucocytes and positive physicochemical findings were 12.25%. 23.7% samples were from male patients, out of which 34% were positive. 76.3% samples were from females, out of which 41.6% were positive. Pyuria was found more in females (29.9%) while hematuria was higher in males (20.9%). 942 (47.1%) samples were received in the morning, 707 (35.4%) in the evening and 351(17.5%) during the night. Pyuria (30.4%) was detected more in evening and proteinuria (18.8%) more in night shifts. The frequency of positive samples increased with age, more so in physico-chemical than microscopic aspect. The price of urine R.E in private sector laboratory is Rs 50-150/test. The cost of 2000 tests is estimated at Rs 100000-300000, out of which Rs 40,000-120,000 were for positive tests and Rs 60,000-180,000 for negative tests.
The detection of abnormal findings in urine was 39.8% Urine RE test indicates fairly satisfactory diagnostic yield. Pyuria was the commonest abnormality seen especially in females. The research and better strategies are needed to improve diagnostic yield in children. The guidance of patients and health care professionals to improve current practices of sample collection and examination can yield more positive results. The clinician should order lab investigations after conscientious justifications.
Urine RE, urinalysis, pyuria, hematuria.