Evidence of dipstick superiority over urine microscopy analysis for detection of hematuria.
BACKGROUND
There is an unresolved debate on the best screening method for hematuria as a symptom of glomerulonephritis or urological malignancies. The urinary dipstick is generally considered as an imperfect surrogate for urine microscopy analysis.


RESULTS
We designed a study to compare urine microscopy analysis, urinary dipstick and flow cytometry, using controlled dilutions of blood in urine samples from volunteers collected in two different physiologically-relevant conditions (basal state and hyperhydration). We found that although all techniques were 100 % effective in detecting hematuria at basal state, these results were variably reproduced when testing the same final amount of hematuria in urine collected after hyperhydration. Our data shows a variable sensitivity for the detection of hematuria by urine microscopy analysis or flow cytometry, but not by urinary dipstick.


CONCLUSIONS
Urinary dipstick qualifies as a better screening test for hematuria than urine microscopy analysis or flow cytometry, as it is sensitive and performs better in unstandardized conditions. It is universally available and also faster and cheaper than cytometric techniques.
Inserm UMR_S 1155, Hôpital Tenon, Paris, France.
Aurélien
A
Bataille
Inserm UMR_S 1155, Hôpital Tenon, Paris, France.
Morgane
M
Wetzstein
Inserm UMR_S 1155, Hôpital Tenon, Paris, France.|Urgences Néphrologiques et Transplantation Rénale, Hôpital Tenon, 4, rue de la Chine, 75020, Paris, France.|Université Pierre et Marie Curie (Paris 6), Sorbonne Universités, Paris, France.
Alexandre
A
Hertig
Inserm UMR_S 1155, Hôpital Tenon, Paris, France.|Service de Bactériologie, Hôpital Tenon, Paris, France.|Université Pierre et Marie Curie (Paris 6), Sorbonne Universités, Paris, France.
Sophie
S
Vimont
Inserm UMR_S 1155, Hôpital Tenon, Paris, France.|Urgences Néphrologiques et Transplantation Rénale, Hôpital Tenon, 4, rue de la Chine, 75020, Paris, France.|Université Pierre et Marie Curie (Paris 6), Sorbonne Universités, Paris, France.
Eric
E
Rondeau
Inserm UMR_S 1155, Hôpital Tenon, Paris, France. pierre.galichon@aphp.fr.|Urgences Néphrologiques et Transplantation Rénale, Hôpital Tenon, 4, rue de la Chine, 75020, Paris, France. pierre.galichon@aphp.fr.|Université Pierre et Marie Curie (Paris 6), Sorbonne Universités, Paris, France. pierre.galichon@aphp.fr.
Pierre
http://orcid.org/0000-0002-2771-1596
P
Galichon
D006417:Hematuria / Q000175:diagnosis* / Q000652:urine; D008853:Microscopy; D012680:Sensitivity and Specificity; D016482:Urinalysis / Q000379:methods*
Hematuria; Screening test; Sensitivity