Screening of proteinuria in young adults: Is it worthwhile?

BACKGROUND The prevalence of chronic kidney disease is increasing rapidly worldwide, and recent data indicate that overt disease is the tip of the iceberg of covert disease. Data on the prevalence and incidence of proteinuria in young adults are scarce. This lack of knowledge is an obstacle to the establishment of prevention programs for chronic kidney disease, especially in developing countries. SETTING AND PARTICIPANTS Urine screening for proteinuria was carried out in a cohort of young adults in a student hostel of Ain Shams University, Cairo, Egypt. Fresh morning urine samples were collected and tested for proteinuria by dipstick analysis. Participants with persistent proteinuria were referred to the university hospital for further evaluation for the presence of kidney disease. RESULTS Of 1,260 apparent healthy students screened, 67.7% were males and 32.3% were females. Their mean age was 20.2 ± 1.2 years. 3.3% were hypertensive, and proteinuria was detected in 47 (3.7%) in the first screening test. At the second screening test, persistent proteinuria was found in 10 students (0.8% of the original cohort). Of these, 4 (0.3%) had proteinuria more than 0.5 g/24 h, but all of them refused renal biopsy. CONCLUSIONS Urine dipstick is an inexpensive way to screen for proteinuria in developing countries, but it must be done twice to exclude transient and intermittent proteinuria. Routine screening for proteinuria in this particular young adult population is not recommended due to its low diagnostic yield.