Emergency Department, Cantonal Hospital of St. Gallen, Rorschacher Strasse 95, CH-9007, St. Gallen, Switzerland.
Heath Technology Assessment Unit, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.
BMC Urol. 2020 Aug 8;20(1):119. doi: 10.1186/s12894-020-00690-7.
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.
A 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.
Forty-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).
This 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.
本系统评价和荟萃分析旨在调查在急诊科就诊的疑似急性肾绞痛和/或确诊尿路结石患者中出现镜下血尿的患病率。
进行了全面的文献检索，以查找有关疑似急性肾绞痛和/或确诊尿路结石患者镜下血尿患病率的相关数据。从每项研究中检索有关研究设计、患者特征和镜下血尿患病率的数据。使用随机效应模型进行汇总分析。
通过文献检索筛选出 49 篇文章，共纳入 15860 例患者。镜下血尿的总体患病率分别为疑似急性肾绞痛 77%（95%CI：73-80%）和确诊尿路结石 84%（95%CI：80-87%）。与显微镜尿分析（急性肾绞痛和尿路结石分别为 74%和 78%）相比，使用尿试纸检测时该比例更高（急性肾绞痛和尿路结石分别为 80%和 90%）。
本荟萃分析显示，急性肾绞痛患者（77%），包括确诊尿路结石患者（84%）中镜下血尿的患病率较高。将该患病率视为敏感性，我们得到了中等程度的值，这使得镜下血尿单独作为急性肾绞痛或尿路结石的诊断检测效果不佳。镜下血尿对于评估肾绞痛患者的风险可能仍然很重要。
