Is it a good idea to screen the pediatric population at-large for hematuria and proteinuria? This is a controversial topic, as generally speaking isolated hematuria or isolated proteinuria are almost always benign findings in pediatric populations, and overly-aggressive work-up (e.g., renal biopsy) in all individuals with these abnormalities would likely result in measurable morbidity.
In favor of routine screening are some studies from Asian populations where urinalysis screening has been more routinely adopted--specifically, this study from Korea and this study from Taiwan--which demonstrate that the rate of pediatric ESRD dropped from 19 per million to 8 per million following these interventions, much of which could be explained by a drop in glomerulonephritis-induced kidney injury.
In the United States, the American Academy of Pediatrics currently recommends that urinalysis be performed only when there is a specific complaint.
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