SCREENING OF RENAL DISEASES IN THE FIRST PRIMARY SCHOOL CHILDREN IN SHIRAZ

Abstract

Screening interval urinalysis has long been considered essential to pediatric health care. A urinalysis is recommended at four times: in infancy, early childhood, late childhood, and in adolescence. Several chemical parameters can be measured as commercially available in dipstick test. This test is relatively inexpensive and it takes less than 5 minutes to be completed. In a 3 month follow up program, mass urine screening tests was conducted in four educational areas of Shiraz, Iran, randomly in 1601 students. The questionnaire was filled by their parents and general physical exam was done by general physicians. Fresh urine specimens were screened using a dipstick for chemical analysis including: protein, glucose, blood, urobilinogen, leukocyte-esterase, bilirubin and nitrite. In those who had urinary abnormalities by dipstick or who were symptomatic or had physical abnormalities further investigations were carried out. In 1601 apparently healthy children (809 boys, 799 girls) urinary abnormalities were detected in 76 (4.7%) subjects at first screening. There were urinary symptoms in 63 patients. The most common form of urinary abnormalities was proteinuria (56 subjects, 3.6%). Followed by hematuria (1%), nitrite (0.6%), leukocyte estrase (0.4%) and glucosuria (0.2%). Abnormality in sonography of kidneys were found in 22 cases. Positive dipstick findings had significant correlation with abnormal ultrasound findings. This study shows that it is possible to screen a large population of patients at relatively low cost, providing the framework for further action that may help in the prevention and timely diagnosis of renal diseases.