Hematuria and proteinuria in a mass school urine screening test.
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.
Park
Yong-Hoon
YH
Department of Pediatrics, Yeungnam University College of Medicine, Daegu, Korea. yhpark@med.yu.ac.kr
Choi
Jung-Youn
JY
Chung
Hyo-Seok
HS
Koo
Ja-Wook
JW
Kim
Su-Yung
SY
Namgoong
Mee-Kyung
MK
Park
Young-Seo
YS
Yoo
Kee-Hwan
KH
Lee
Kyung-Yil
KY
Lee
Dae-Yeol
DY
Lee
Seung-Joo
SJ
Lee
Ji-Eun
JE
Chung
Woo-Yeong
WY
Hah
Tae-Sun
TS
Cheong
Hae-Il
HI
Choi
Yong
Y
Lee
Kyung-Soo
KS
D000293:Adolescent; D002648:Child; D005260:Female; D006417:Hematuria / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D007678:Kidney Glomerulus / Q000473:pathology; D007723:Korea / Q000453:epidemiology; D008297:Male; D008403:Mass Screening; D011507:Proteinuria / Q000453:epidemiology* / Q000473:pathology