Abstract
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.
Similar content being viewed by others
References
Korean Society of Nephrology, Registry Committee (2003) Renal replacement therapy in Korea. Korean J Nephrol 22:s353–368
Fraser CG, Smith BC, Peake MJ (1977) Effectiveness of an outpatient urine screening program. Clin Chem 23:2216–2218
Murakami M, Yamamoto H, Ueda Y, Murakami K, Yamauchi K (1991) Urinary screening of elementary and junior high-school children over a 13-year period in Tokyo. Pediatr Nephrol 5:50–53
Kitagawa T (1988) Lessons learned from the Japanese nephritis screening study. Pediatr Nephrol 2:256–263
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 1:1–24
Vehaskari VM, Rapola J (1982) Isolated proteinuria: analysis of a school-age population. J Pediatr 101:661–668
Kim CM, Hhn HW, Lee BS, Park YS (2002) Analysis of isolated proteinuria on school urinary mass screening. J Korean Soc Pediatr Nephrol 6:61–67
Auwardt R, Savige J, Wilson D (1999) A comparison of the clinical and laboratory features of thin basement membrane disease (TBMD) and IgA glomerulonephritis (IgA GN). Clin Nephrol 52:1–4
Kim SH, Cho SW, Kim HD, Chung JW, Park JH, Han MC (1996) Nutcracker syndrome: diagnosis with Doppler US. Radiology 198:93–97
Park SJ, Lim JW, Cho BS, Yoon TY, Oh JH (2002) Nutcraker syndrome in children with orthostatic proteinuria: Diagnosis on the basis of Doppler sonography. J Ultrasound Med 21:39–45
Auwardt R, Savige J, Wilson D (1999) A comparison of the clinical and laboratory features of thin basement membrane disease (TBMD) and IgA glomerulonephritis (IgA GN). Clin Nephrol 52:1–4
Roth KS, Amaker BH, Chan JC (2001) Pediatric hematuria and thin basement membrane nephropathy: what is it and what does it mean? Clin Pediatr 40:607–613
Trachtman H, Weiss RA, Bennett B, Greifer I (1984) Isolated hematuria in children: indications for a renal biopsy. Kidney Int 25:94–99
Miller PFW, Speirs NI, Apricio SR, Lendon M, Savage JM, Postlethwaite RJ, Brocklebank JT, Houston IB, Meadow SR (1985) Long-term prognosis of recurrent haematuria. Arch Dis Child 60:420–425
Vehaskari VM, Rapola J (1982) Isolated proteinuria: analysis of school-age population. J Pediatr 101:661–668
Hisano S, Ueda K (1989) Asymptomatic heamaturia and proteinuria: renal pathology and clinical outcome in 54 children. Pediatr Nephrol 3:229–234
Hattori S, Karashima S, Furuse A, Terashima T, Hiramatsu M, Murakami M, Matsuda I (1985) Clinicopathological correlation of IgA nephropathy in children. Am J Nephrol 5:182–189
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 32:710–715
Murakamia M, Ueda Y, Murakami K (1985) Management of children with chronic diseases at school—renal disease. Acta Paediatr Jpn Overseas Ed 27:406–414
Acknowledgements
This work was a collaboration supported by a grant from the Korean Society of Pediatric Nephrology.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Park, YH., Choi, JY., Chung, HS. et al. Hematuria and proteinuria in a mass school urine screening test. Pediatr Nephrol 20, 1126–1130 (2005). https://doi.org/10.1007/s00467-005-1915-8
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00467-005-1915-8