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Urinalysis is an important diagnostic test for kidney and urinary tract diseases. Nephrologists typically request a comprehensive urine analysis using a dipstick, a widely accepted and cost-effective method. However, the examination of urinary sediment, which can provide valuable insights, is often overlooked. Currently, the analysis of urinary sediment is typically conducted remotely in centralized laboratories away from the patient’s bedside and may lack the required methodologies and specialized knowledge. Properly conducted urinalysis is crucial in diagnosing and managing kidney conditions, along with other tests and imaging.
A cross-sectional survey was conducted among nephrologists in Africa using an online survey questionnaire via Google Forms. The questionnaire was distributed on the WhatsApp LLC platform of the African Nephrologists, reaching a total of 465 nephrologists from various African countries. Of these, 122 nephrologists from 17 countries responded to the assessment of urinalysis practices, levels of confidence in interpreting urinalysis for diagnosis, and the obstacles hindering its effective utilization.
The survey participants consisted primarily of males (73.8%), predominantly nephrologists from Nigeria (37.7%). In general, the majority of respondents frequently request urinalysis, particularly for chronic kidney disease (86.1%). Surprisingly, a considerable proportion (29.5%) of the respondents lacked confidence in interpreting urinalysis findings, despite the fact that the majority (33.6%) expressed high confidence. However, only 9% of respondents rarely incorporate urinalysis with other diagnostic techniques. The primary obstacles to the effective utilization of urinalysis among the participants were insufficient expertise (60.7%) and the lengthy time required for interpretation (59%).
Multiple choice questions
Responses
n (%)
How often does urinalysis influence your treatment decision?
Rarely
14 (11.5)
Occasionally
41 (33.6)
Frequently
50 (41.0)
Always
17 (13.9)
How often do you engage in continuing medical education related to urinalysis and kidney disease?
30 (24.6)
Often
32 (26.2)
Very often
10 (8.2)
How frequently do you order urinalysis for your patients?
20 (16.4)
37 (30.3)
55 (45.1)
How often do you integrate urinalysis results with other diagnostic techniques in your clinical practice?
11 (9.0)
38 (31.1)
African nephrologists commonly utilize urinalysis in their clinical practice; however, there exists a notable deficiency in understanding the interpretation of urinalysis findings. The primary obstacle hindering the effective application of urinalysis by African nephrologists is a lack of proficiency in performing the procedure, compounded by the significant amount of time it requires. Consequently, there is a pressing requirement for comprehensive training and institutional support to enhance diagnostic capabilities.