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Evaluation of screening with urine dipsticks and renal ultrasonography for 3-year-olds in Chiba City over 30 years

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Abstract

Background

Urinary screening for 3-year-olds cannot adequately detect congenital anomalies of the kidney and urinary tract (CAKUT).

Methods

Urinary screening for 3-year-olds was investigated over 30 years. Dipsticks for proteinuria, hematuria, glycosuria, leukocyturia, and nitrite at first screening, and dipsticks, urinary sediments, and renal ultrasonography at second screening were performed. Screening results were evaluated.

Results

The positive rates of proteinuria, hematuria, leukocyturia, and nitrite relative to 218,831 children at the first screening were 1.0%, 4.6%, 2.3%, and 0.88%, respectively. Thirty-seven glomerular disease, 122 CAKUT, and 5 urological disease cases were found. We detected 6 stage 3–4 chronic kidney disease (CKD) and 3 end-stage kidney disease cases, including 3 CAKUT, comprising 2 bilateral renal hypoplasia and 1 vesicoureteral reflux (VUR), and 6 glomerular diseases, comprising 4 focal segmental glomerulosclerosis and 2 Alport syndrome. The positive rates relative to 218,831 children and CKD detection rates for each tentative diagnosis of mild hematuria, severe hematuria, proteinuria and hematuria, proteinuria, and suspected urinary tract infection were 1.4% and 0.67%, 0.11% and 3.7%, 0.01% and 28.6%, 0.02% and 45.0%, and 0.08% and 9.7%, respectively. Among 14 VUR cases with significant bacteriuria, 13 were found by leukocyturia, 12 had grade ≥ IV VUR, and 10 had severe renal scars.

Conclusions

Nine stage 3–5 CKD cases comprising 3 CAKUT and 6 glomerular disease were found by urinary screening of 3-year-olds among 218,831 children. The combination of urine dipsticks including leukocyturia at the first screening and ultrasonography at the second screening appeared useful.

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Acknowledgements

The authors thank Dr. H. Oshima (Chiba Aoba Municipal Hospital), Dr. M. Kanazawa (Chiba Kaihin Municipal Hospital), Dr. F. Sudo (National Hospital Organization Chiba Medical Center), and other members of the committee concerning CKD in preschool children for providing valuable data and considerable efforts.

Author information

Authors and Affiliations

  1. Department of Pediatrics, National Hospital Organization Chibahigashi National Hospital, 673 Nitona-cho, Chuo-ku, Chiba, 260-8712, Japan

    Chieko Matsumura, Katsuyoshi Kanemoto, Yuichi Uno, Masayo Kobayashi & Mai Masuda

  2. Department of Nephrology, National Hospital Organization Chibahigashi National Hospital, 673 Nitona-cho, Chuo-ku, Chiba, 260-8712, Japan

    Toshiyuki Imasawa

  3. Department of Nephrology, Chiba Children’s Hospital, 579-1 Heta-cho, Midori-ku, Chiba, 266-0007, Japan

    Masataka Hisano

  4. Department of Urology, Chiba Children’s Hospital, 579-1 Heta-cho, Midori-ku, Chiba, 266-0007, Japan

    Sumie Homma

  5. Department of Nephrology, Tokyo Metropolitan Children’s Medical Center, 2-8-29 Musashidai, Fuchu, Tokyo, 183-8561, Japan

    Masataka Honda

  6. Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan

    Kandai Nozu

  7. Health Department of Chiba City, 1-3-9 Saiwai-cho, Mihama-ku, Chiba, 261-8755, Japan

    Junichi Yamaguchi

Authors
  1. Chieko Matsumura
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  2. Katsuyoshi Kanemoto
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  3. Yuichi Uno
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  4. Masayo Kobayashi
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  5. Mai Masuda
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  6. Toshiyuki Imasawa
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  7. Masataka Hisano
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  8. Sumie Homma
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  9. Masataka Honda
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  10. Kandai Nozu
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  11. Junichi Yamaguchi
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Contributions

CM, KK, YU, and M. Honda: contributed to the study’s conception and design. Data acquisition was performed by CM, KK, YU, MK, MM, TI, M. Hisano, SH, and JY. Data analysis of kidney length was performed by CM and M. Honda, and other data analysis was performed by CM. Genetic analysis was performed by KN. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Chieko Matsumura.

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Conflict of interest

The authors have declared that no conflicts of interest exist.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the Ethics Committee of National Hospital Organization Chibahigashi National Hospital (Approval number: R3-13).

Consent to participate

Urinary screening for 3-year-olds is a legally required healthcare measure enforced by the Child Welfare Law. This was a retrospective and observational study without any intervention. Informed consent was obtained from the patient who underwent genetic analysis.

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Matsumura, C., Kanemoto, K., Uno, Y. et al. Evaluation of screening with urine dipsticks and renal ultrasonography for 3-year-olds in Chiba City over 30 years. Clin Exp Nephrol 26, 1208–1217 (2022). https://doi.org/10.1007/s10157-022-02265-2

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  • DOI: https://doi.org/10.1007/s10157-022-02265-2

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