School urinalysis screening in Shanghai

Background: School screening program is justified to identify children with asymptomatic and progressive renal diseases by dipstick urinalysis. Since little is known about the prevalence of hematuria and proteinuria in China, this urine screening program was conducted to detect the prevalence of abnormal urine dipstick in school children in Shanghai and to set up a more effective screening program for children in China. Methods: Urinary screening was carried out in 25 primary and middle schools in Xuhui District, Shanghai during the period from March to October 2003. The first morning urine specimen obtained from each student was tested with urine dipstick for protein, blood and glucose. Students with abnormal screening results were retested. Those who had abnormal results twice were subjected to a systematic clinical evaluation, renal function study and renal biopsy, if necessary. Results: Of 23 208 students screened, 22 657 provided urine samples, of which 1637 (7.2%) were abnormal. Reexamination of 1553 students found that 255 (1.13%) of them showed urinary abnormality. In the 255 students, 104 (0.46%) had hematuria, 116 (0.51%) proteinuria, 15 (0.07%) both hematuria and proteinuria, and 14 (0.06%) glucosuria. Analysis of the prevalence of urinary abnormality in students of different ages showed that the prevalence increased with the age, and the peak was seen at 12 years old. Follow-up revealed 3 students suffered from diabetes and 2 IgA nephropathy. Conclusions: Asymptomatic hematuria and proteinuria might be detected by the school screening program, a way for early management of some diseases like IgA nephropathy. The program might be cost-effective if students are screened at the age of 12. World J Pediatr 2006;3:195-198