Guidelines for screening with urinary dipsticks differ substantially--a systematic review

INTRODUCTION: Urinary dipsticks are frequently used for screening as part of health checks and at hospital admission, but the benefits and harms of this are unknown.

MATERIAL AND METHODS: Health authorities and a selection of specialist societies in nine countries were identified through internet searches. Recommendations on dipstick screening at health checks or hospital admission were sought on websites as well as by e-mail contact. Other relevant organisations encountered were also included. Recommendations were summarised narratively.

RESULTS: A total of 67 organisations were included. No positive or negative recommendations were found regarding screening with combined dipsticks. Screening for bacteriuria in non-pregnant persons was discouraged, while guidance on screening with dipsticks for haemoglobin, glucose and protein was uncommon and often unclear.

CONCLUSION: Useful guidance was rare. Practitioners are largely left to themselves when deciding whether or not to offer screening with urinary dipsticks. This situation needs to be remedied as benefit has not been shown and because screening with dipsticks can cause harm.