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School urinary screening program in Japan: history, outcomes, perspectives.
Masataka Honda1, Takeshi Yanagihara2, Yoshimitsu Gotoh3
1Department of Nephrology and Clinical Research Support Center, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
Kidney Research and Clinical Practice
|May 13, 2024
Summary
Japan
Area of Science:
- Pediatric Nephrology
- Public Health Screening
- Urology
Background:
- School-based urinary screening for asymptomatic kidney disease in Japan began in 1974.
- This program has successfully reduced kidney failure in children and young adults.
- It contrasts with the US recommendation to discontinue routine urinalysis in children.
Purpose of the Study:
- To evaluate the effectiveness and identify areas for improvement in Japan's pediatric urinary screening program.
- To highlight the success of early detection and treatment of glomerulonephritis, including IgA nephropathy.
- To compare the false positive rates between Japan and the US.
Main Methods:
- Analysis of long-term data from Japan's national pediatric urinary screening program.
- Comparison of screening methodologies and positivity rates with international practices.
- Review of recommended diagnostic follow-ups, including beta-2 microglobulin testing and ultrasonography for congenital anomalies.
Main Results:
- Japan's screening program has significantly lowered the incidence of kidney failure in pediatric populations.
- The program demonstrates a lower false positive rate compared to the US.
- Variations in screening methods and a need for improved detection of congenital anomalies were identified.
Conclusions:
- Continued pediatric urinary screening in Japan is crucial for early kidney disease detection and prevention of kidney failure.
- Optimizing screening protocols and incorporating advanced diagnostics are necessary for system enhancement.
- Japan's model offers valuable insights for international pediatric kidney health initiatives.
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