title: Ultrasound screening for renal and urinary tract anomalies in healthy infants.
abstract: BACKGROUND
  Nearly 30% of childhood cases of chronic renal failure in Japan are attributed to congenital anomalies of the kidney and urinary tract (CAKUT), and the number is increasing. Urine screening at school facilitates early diagnosis and treatment of glomerulonephritis, but early screening for anomalies is currently not in practice. The authors evaluated the value of early abdominal ultrasonography screening in 1-month-old infants.
  
  
  METHODS
  The following characteristics of kidneys were assessed: presence versus absence, size, symmetry of size, position, separation of the central echo complex (CEC), abnormal echogenicity, and other abnormal findings. The bladder and ureter were checked for abnormalities in bladder shape and wall, as well as retrovesical ureteral dilation. Criteria for abnormalities included kidney length of <or=35 mm, or >or=60 mm; a difference in length of left and right kidneys of 10 mm or more; and CEC separation of Society for Fetal Urology (SFU) grade 2 or higher.
  
  
  RESULTS
  Beginning in April 1994 and continuing until September 2001, screening of 5700 1-month-old infants yielded 198 positive cases (3.5%) of CAKUT. Most frequent was abnormal CEC separation (approximately 60% of all abnormalities), followed by abnormal renal size or size asymmetry (30%). Further investigation yielded a specific diagnosis in 32 cases (0.6%) of all subjects. Most prevalent was obstructive uropathy (15 cases); 8 children underwent surgery. Small kidneys and vesicoureteral reflux were next in frequency.
  
  
  CONCLUSIONS
  Ultrasonograpy was effective for early detection of renal and urinary tract anomalies. Ultrasound screening in early infancy may permit early treatment, that can prevent renal dysfunction.
authors.affiliation: Department of Pediatrics and Child Health, Nippon Medical School, Chiba, Japan. tsuchiya_masami/pediatrics@nms.ac.jp
authors.forename: Masami
authors.initials: M
authors.lastname: Tsuchiya
authors.forename: Mari
authors.initials: M
authors.lastname: Hayashida
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yanagihara
authors.forename: Junko
authors.initials: J
authors.lastname: Yoshida
authors.forename: Sachiyo
authors.initials: S
authors.lastname: Takeda
authors.forename: Noriko
authors.initials: N
authors.lastname: Tatsuma
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Tsugu
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Hino
authors.forename: Emiko
authors.initials: E
authors.lastname: Munakata
authors.forename: Mutsumi
authors.initials: M
authors.lastname: Murakami
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007564:Japan; D007668:Kidney / Q000002:abnormalities / Q000000981:diagnostic imaging*; D008297:Male; D008403:Mass Screening; D014463:Ultrasonography; D014551:Urinary Tract / Q000002:abnormalities / Q000000981:diagnostic imaging*