Abstract
BackgroundThis systematic review and meta-analysis aims to investigate the prevalence of microhematuria in patients presenting with suspected acute renal colic and/or confirmed urolithiasis at the emergency department.MethodsA comprehensive literature search was conducted to find relevant data on prevalence of microhematuria in patients with suspected acute renal colic and/or confirmed urolithiasis. Data from each study regarding study design, patient characteristics and prevalence of microhematuria were retrieved. A random effect-model was used for the pooled analyses.ResultsForty-nine articles including 15′860 patients were selected through the literature search. The pooled microhematuria prevalence was 77% (95%CI: 73–80%) and 84% (95%CI: 80–87%) for suspected acute renal colic and confirmed urolithiasis, respectively. This proportion was much higher when the dipstick was used as diagnostic test (80 and 90% for acute renal colic and urolithiasis, respectively) compared to the microscopic urinalysis (74 and 78% for acute renal colic and urolithiasis, respectively).ConclusionsThis meta-analysis revealed a high prevalence of microhematuria in patients with acute renal colic (77%), including those with confirmed urolithiasis (84%). Intending this prevalence as sensitivity, we reached moderate values, which make microhematuria alone a poor diagnostic test for acute renal colic or urolithiasis. Microhematuria could possibly still important to assess the risk in patients with renal colic.
Highlights
This systematic review and meta-analysis aims to investigate the prevalence of microhematuria in patients presenting with suspected acute renal colic and/or confirmed urolithiasis at the emergency department
Renal colic is caused by the presence of stones in the urinary tract and it is characterized by sudden onset of severe loin pain, radiating to the flank, groin, and testes or labia majora [1]
Eligibility criteria We included in this systematic review and meta-analysis studies which filled the following inclusion criteria: a) original article published in peer-reviewed journal; b) studies including adults only; c) patients presenting with acute renal colic at the emergency department; d) studies reporting data on microhematuria
Summary
This systematic review and meta-analysis aims to investigate the prevalence of microhematuria in patients presenting with suspected acute renal colic and/or confirmed urolithiasis at the emergency department. Incidence amounts to 240 per 100′ 000 persons [2] with a prevalence up to 10%; men are commonly more affected than women with a ratio of 3–. As diagnostic tool the STONE Score was developed and validated; this score includes parameters as sex, duration of pain prior to presentation, race, nausea, vomiting and microhematuria [6]. Microhematuria prevalence in suspected renal colic has been studied in several trials, ranging from 55% [7] to 93% [8, 9].
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