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Urinary Screening in Asymptomatic Indian Children: A Cross Sectional Epidemiological Study
Mithu Banerjee1, Dipayan Roy2, Malavika Lingeswaran3
1Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India.
Insights
Routine urine screening in Indian school children can detect asymptomatic kidney diseases early. This study found specific prevalences of hematuria and proteinuria, highlighting the need for timely intervention in pediatric renal health.
Area of Science:
- Pediatric Nephrology
- Public Health Screening
- Urology
Background:
- Paediatric chronic kidney disease progression can be reduced by early detection and management of renal abnormalities.
- Data on the prevalence of abnormal urinary parameters in the Indian population are limited.
- Asymptomatic kidney diseases in children often go undetected, necessitating targeted screening strategies.
Purpose of the Study:
- To determine the prevalence of asymptomatic kidney diseases in Indian school children.
- To identify children who would benefit from routine urinary screening for early identification and intervention.
- To assess the utility of dipstick urinalysis for detecting renal abnormalities in a pediatric population.
Main Methods:
- A total of 1675 school children aged 5-19 years in North India were screened.
- Dipstick tests were used to detect hematuria and proteinuria in midstream urine specimens.
- Children with positive results underwent urine microscopy; hypertensive children were also assessed for urinary abnormalities.
Main Results:
- The prevalence of isolated hematuria was 1.9%, isolated proteinuria 0.35%, and glycosuria 0.06% in the screened population.
- Urine microscopy revealed abnormal findings in 44 children, with isolated hematuria (34%) and isolated white blood cells (47.7%) being most common.
- Hypertensive children showed higher prevalence of proteinuria (0.60%) and hematuria (2.99%) compared to healthy children.
Conclusions:
- Urine screening is a cost-effective, non-invasive method for early detection of occult renal diseases in children.
- Further large-scale studies with follow-up are needed to establish the benefits of a national pediatric urine screening program.
- Identifying urinary abnormalities in school children can facilitate timely intervention to prevent chronic kidney disease progression.
Background And Aims:
Early detection and management of renal abnormalities in children can reduce the progression of paediatric chronic kidney disease. Currently, data on the prevalence of routine abnormal urinary parameters are scarce in Indian population. This study aims to identify the prevalence of asymptomatic kidney diseases in Indian school children and the population who may benefit from routine urinary screening tests for timely identification and intervention of asymptomatic renal diseases.
Materials And Methods:
A total of 1675 children from a North Indian, multiethnic population aged 5-19 years were screened for hematuria and proteinuria by dipstick test from a midstream, clean urine specimen. The children who tested positive had their urine tested further for microscopy. The incidences of proteinuria and hematuria were also separately checked in hypertensive children.
Results:
76 children had urinary abnormalities with the prevalence of isolated haematuria in 1.9%, isolated proteinuria in 0.35% and glycosuria in 0.06%. When these children were followed with urine microscopy, 44 were observed to have abnormal findings. Of these, 4.5% children had proteinuria, 34% had isolated hematuria, and 47.7% had isolated WBCs. The prevalence for proteinuria was 0.60% and the prevalence for hematuria was 2.99% (in upper decile of SBP) in hypertensive children, both of which were more than the prevalence in otherwise healthy children.
Conclusion:
Urine screening is a non-invasive, inexpensive test for early detection of occult renal diseases. A large-scale study with follow-up of children with urinary abnormalities will further establish the benefit, if any, of a national paediatric urine screening programme.
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