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Renal tract abnormalities detected in Australian preschool children
R J Hogg1, S Harris, D M Lawrence
1Renal Unit, Women's and Children's Hospital, North Adelaide, South Australia, Australia.
Insights
Many Australian preschool children have undiagnosed renal tract abnormalities, often detectable through urinalysis and blood pressure screening. Early detection through these methods is crucial for identifying potential kidney disease in this age group.
Area of Science:
- Pediatric Nephrology
- Community Health Screening
- Diagnostic Accuracy
Background:
- Undiagnosed renal tract abnormalities are a concern in preschool populations.
- Early identification is key to preventing long-term kidney disease complications.
Purpose of the Study:
- To determine the incidence of urinalysis and blood pressure abnormalities in Australian preschoolers.
- To assess the predictive value of these findings for detecting renal disease.
Main Methods:
- Screened 9355 South Australian preschool children for urinary and blood pressure abnormalities.
- Investigated 743 children with abnormal results and 357 controls in a nephrology clinic.
Main Results:
- 0.81% of children had clinically significant renal tract abnormalities, including UTIs, reflux, and hypertension.
- Dipstick urinalysis, blood pressure, and beta2-microglobulin were key indicators.
- Screening for glycosuria was not effective for detecting significant abnormalities.
Conclusions:
- A significant number of Australian preschoolers have undiagnosed renal tract abnormalities.
- Thorough history, examination, and urinalysis are effective screening tools.
Objective:
To quantify the incidence of abnormalities in urinalysis and blood pressure from preschool children and their predictive value in detecting renal disease within an Australian community.
Methodology:
Urine samples, blood pressure and height measurements and parental reports of significant medical problems were collected from a total of 9355 South Australian preschool children. Seven hundred and forty-three children with abnormal results were investigated in a nephrology outpatient clinic. A control group of 357 children with no detectable abnormality were also recalled, examined and, where appropriate, investigated.
Results:
Nine thousand, three hundred and fifty-five children were tested. Of these, 0.81% were shown to have a clinically significant renal tract abnormality. The findings included children with urinary tract infections, vesico-ureteric reflux, glomerular disease, renal calculi, essential hypertension and a renal neoplasm. While dipstick-based methods were the most specific indicators of renal tract abnormalities, measurement of blood pressure and urinary beta2-microglobulin were also important in detecting abnormalities. Screening for glycosuria did not result in the detection of significant undiagnosed abnormalities. In the control group with no abnormality detected at testing, there was one case each of aortic coarctation, polycystic kidney disease and vesico-ureteric reflux diagnosed.
Conclusion:
Undiagnosed renal tract abnormalities are present in many Australian preschool children. Most are detectable by a thorough history, examination and urinalysis.
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