背景:3岁儿童的泌尿系统筛查不能充分发现肾脏和泌尿道(CAKUT)的先天性异常。
方法:调查了30多年来3岁儿童的尿液筛查。蛋白尿试纸,血尿,糖尿,白细胞增多症,和亚硝酸盐在第一次筛选时,和量油尺,尿沉渣,在第二次筛查时进行肾脏超声检查。评价筛选结果。
结果:蛋白尿的阳性率,血尿,白细胞增多症,在第一次筛查时,亚硝酸盐相对于218,831名儿童为1.0%,4.6%,2.3%,和0.88%,分别。37肾小球疾病,122CAKUT,发现泌尿系疾病5例。我们检测到6例3-4期慢性肾脏病(CKD)和3例终末期肾脏病病例,包括3个CAKUT,包括2例双侧肾发育不全和1例膀胱输尿管反流(VUR),和6种肾小球疾病,包括4个局灶节段性肾小球硬化和2个Alport综合征。每个初步诊断为轻度血尿的相对于218,831名儿童的阳性率和CKD检出率,严重血尿,蛋白尿和血尿,蛋白尿,可疑尿路感染分别为1.4%和0.67%,0.11%和3.7%,0.01%和28.6%,0.02%和45.0%,0.08%和9.7%,分别。在14例VUR患者中,有明显的菌尿,13个是由白细胞增多症发现的,12有≥IV级VUR,和10有严重的肾脏疤痕。
结论:在218,831名儿童中,通过3岁儿童的尿液筛查发现了9例3-5期CKD病例,包括3例CAKUT和6例肾小球疾病。尿液试纸包括第一次筛查时的白细胞增多和第二次筛查时的超声检查的组合似乎是有用的。
BACKGROUND: Urinary screening for 3-year-olds cannot adequately detect congenital anomalies of the kidney and urinary tract (CAKUT).
METHODS: Urinary screening for 3-year-olds was investigated over 30 years. Dipsticks for proteinuria, hematuria, glycosuria, leukocyturia, and nitrite at first screening, and dipsticks, urinary sediments, and renal ultrasonography at second screening were performed. Screening results were evaluated.
RESULTS: The positive rates of proteinuria, hematuria, leukocyturia, and nitrite relative to 218,831 children at the first screening were 1.0%, 4.6%, 2.3%, and 0.88%, respectively. Thirty-seven glomerular disease, 122 CAKUT, and 5 urological disease cases were found. We detected 6 stage 3-4 chronic kidney disease (CKD) and 3 end-stage kidney disease cases, including 3 CAKUT, comprising 2 bilateral renal hypoplasia and 1 vesicoureteral reflux (VUR), and 6 glomerular diseases, comprising 4 focal segmental glomerulosclerosis and 2 Alport syndrome. The positive rates relative to 218,831 children and CKD detection rates for each tentative diagnosis of mild hematuria, severe hematuria, proteinuria and hematuria, proteinuria, and suspected urinary tract infection were 1.4% and 0.67%, 0.11% and 3.7%, 0.01% and 28.6%, 0.02% and 45.0%, and 0.08% and 9.7%, respectively. Among 14 VUR cases with significant bacteriuria, 13 were found by leukocyturia, 12 had grade ≥ IV VUR, and 10 had severe renal scars.
CONCLUSIONS: Nine stage 3-5 CKD cases comprising 3 CAKUT and 6 glomerular disease were found by urinary screening of 3-year-olds among 218,831 children. The combination of urine dipsticks including leukocyturia at the first screening and ultrasonography at the second screening appeared useful.