Renal histological features of school-age children with asymptomatic haematuria and/or proteinuria: a multicenter study.
OBJECTIVE
The risk of asymptomatic haematuria and/or proteinuria development into chronic progressive glomerulonephritis (CPG) is unclear. The indications for renal biopsy and follow-up on these asymptomatic children remain controversial.


METHODS
A multicenter, retrospective study was performed to investigate the renal histological features of school-age children with asymptomatic urine abnormalities.


RESULTS
A total of 112 asymptomatic children's renal biopsy data were studied. Most of the children (71%) received a renal biopsy because of isolated microscopic haematuria (IH), and these children were predominantly (60%) proven to have only mild lesions in the glomeruli. Approximately 30% of the children were biopsied because of asymptomatic proteinuria with or without microscopic haematuria (HP or isolated asymptomatic proteinuria (IP)), and these children were mostly (44-83%) indicated to have CPG, such as IgA nephropathy, focal segmental glomerulosclerosis, and Alport syndrome. The junior high school students had a greater percentage of HP than the primary school children. IgA nephropathy was the most common diagnosis in children who received renal biopsy because of HP.


CONCLUSIONS
Our findings indicate that IP and especially HP may have a high risk of development into CPG. IH, however, has a relatively low risk of severe histological lesions. Thus, IH per se might not be suggested as an indication for early renal biopsy. Long-term follow-up is necessary for these asymptomatic children.
Department of Nephrology and Rheumatology, Children's Hospital of Fudan University, Shanghai, China.
Yihui
Y
Zhai
Hong
H
Xu
Qian
Q
Shen
Qi
Q
Cao
Guanghua
G
Zhu
Minjiang
M
Wei
Li
L
Sun
Haimei
H
Liu
Jia
J
Rao
Xiaoyan
X
Fang
Jing
J
Chen
Wei
W
Guo
D058070:Asymptomatic Diseases / Q000453:epidemiology*; D001706:Biopsy; D002648:Child; D002681:China / Q000453:epidemiology; D042241:Early Diagnosis; D005260:Female; D005921:Glomerulonephritis / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D006417:Hematuria / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D007668:Kidney / Q000473:pathology; D008297:Male; D011379:Prognosis; D011507:Proteinuria / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D012189:Retrospective Studies; D020379:Risk Adjustment
glomerulonephritis; haematuria; proteinuria; renal biopsy; urinalysis