Hematuria and proteinuria in a mass school urine screening test
- 595 Downloads
A total of 1,044 school children identified with hematuria and/or proteinuria during a mass school urine screening test were referred to pediatric nephrologists at 13 hospitals in Korea. These children had isolated hematuria (IH) (60.1%), isolated proteinuria (IP) (26.4%: transient, 19.6%; orthostatic, 4.9%; persistent, 1.9%) or combined hematuria and proteinuria (CHP) (13.5%). The patient’s history, physical examination, laboratory tests, kidney ultrasound and Doppler ultrasonography were obtained. Renal biopsies were performed on 113 children who showed severe proteinuria, hypertension, abnormal renal function, family history of chronic renal disease, systemic diseases or persistent hematuria and/or proteinuria for more than 12 months. IgA nephropathy (IgAN), thin basement membrane nephropathy (TBMN), membranoproliferative glomerulonephritis (MPGN), focal segmental glomerulosclerosis (FSGS), other GN, Alport syndrome and lupus nephritis were detected. IgAN and TBMN were the most common causes in the CHP group and IH group, respectively. Abnormal findings on the renal ultrasound with or without Doppler ultrasonography were noted in 147 cases (suspected nutcracker phenomenon, 65; increased parenchymal echogenicity, 40; hydronephrosis, 15). This study showed that the use of a mass school urine screening program can detect chronic renal disease in its early stage and recommends that more attention should be paid to identifying those children with CHP and massive proteinuria. A school urine screening program can detect chronic renal disease in its early stage. When mass screening is used, the initial aggressive diagnostic procedures such as renal biopsy are not needed. In addition, a regular follow-up for those children with IH and IP is certainly warranted.
KeywordsHematuria Proteinuria School urine mass screening Chronic renal disease
This work was a collaboration supported by a grant from the Korean Society of Pediatric Nephrology.
- 1.Korean Society of Nephrology, Registry Committee (2003) Renal replacement therapy in Korea. Korean J Nephrol 22:s353–368Google Scholar
- 5.Ministry of Education and Human Resources Development, Educational Statistics System (2002) Sum of results in laboratory tests for school children. Statistical Yearbook of the Korean Ministry of Education and Human Resources Development 1:1–24Google Scholar
- 7.Kim CM, Hhn HW, Lee BS, Park YS (2002) Analysis of isolated proteinuria on school urinary mass screening. J Korean Soc Pediatr Nephrol 6:61–67Google Scholar
- 9.Kim SH, Cho SW, Kim HD, Chung JW, Park JH, Han MC (1996) Nutcracker syndrome: diagnosis with Doppler US. Radiology 198:93–97Google Scholar
- 12.Roth KS, Amaker BH, Chan JC (2001) Pediatric hematuria and thin basement membrane nephropathy: what is it and what does it mean? Clin Pediatr 40:607–613Google Scholar
- 18.Ito K, Kawaguchi H, Hattori M (1990) Screening fot proteinuria and hematuria in school children-is it possible to reduce the incidence of chronic renal failure in children and adolescents? Acta Pediatr Jpn 32:710–715Google Scholar
- 19.Murakamia M, Ueda Y, Murakami K (1985) Management of children with chronic diseases at school—renal disease. Acta Paediatr Jpn Overseas Ed 27:406–414Google Scholar