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Screening system for asymptomatic renal disease in children in Japan
1Kidney Center, Kitasato University Hospital, Sagamihara, Japan.
Insights
Routine urinalysis in Japanese children has identified many asymptomatic cases of chronic progressive renal disease. Early detection through school screenings aids in understanding disease progression and pathogenesis.
Area of Science:
- Pediatric Nephrology
- Clinical Diagnostics
Background:
- Routine urinalysis screening for pre-school and school-aged children in Japan facilitates early detection of renal disease.
- Chronic progressive renal disease (CPRD) often presents asymptomatically in pediatric populations.
Purpose of the Study:
- To evaluate the impact of routine urinalysis on identifying asymptomatic renal disease in children.
- To analyze the types of renal diseases detected and their histological characteristics in early stages.
Main Methods:
- Retrospective analysis of 113 pediatric patients with CPRD diagnosed via renal biopsy at Kitasato University Hospital over 8 years.
- Identification of patients diagnosed through routine school-based urinalysis screenings.
Main Results:
- 31 out of 113 patients (27.4%) with CPRD were initially detected through routine school urinalysis.
- Commonly diagnosed conditions in asymptomatic children included Mesoparenchymal Glomerulonephritis (MPGN), Focal Segmental Glomerulosclerosis (FGS), and IgA nephropathy.
- Histological findings provided crucial guidance for therapeutic planning in early-stage renal diseases.
Conclusions:
- Routine urinalysis is effective in discovering asymptomatic renal disease in children.
- Early detection and histological evaluation are vital for managing progressive renal conditions and investigating disease pathogenesis.
Abstract:
The introduction in Japan of routine urinalysis for pre-school and school age children has greatly facilitated the discovery of renal disease in asymptomatic children. Over the past 8 years at Kitasato University Hospital, we have studied 113 cases of chronic progressive renal disease based on renal biopsy. Thirty-one of these 113 patients were found by routine urinalysis at area schools. It is note-worthy that many of the asymptomatic children were found to have renal diseases such as MPGN, FGS, and IgA nephropathy. Although it is difficult to decide whether or not medical management is required for asymptomatic children, the histological findings may give pertinent guidance for planning an appropriate therapeutic program in the early stages of various types of renal disease. This early detection may enable us to observe these potentially progressive renal diseases from the early phase and to provide clues for the investigation of the pathogenesis of these renal diseases.