Ashraf Bakr, Amr Sarhan, Ayman Hammad, Mohamed Ragab, Osama S Salama, Fatma Al-Husseni, Mohamed Azmy

Mansoura, Egypt

Author Affiliations: Department of Pediatric Nephrology (Bakr A, Sarhan A, Hammad A, Ragab M); Department of Clinical Pathology (Salama OS); Department of Pathology (Al-Husseni F); Department of Community Medicine (Azmy M), Mansoura University Children's Hospital, Mansoura University, Mansoura, Egypt

Corresponding Author: Ashraf Bakr, MD, PhD, Mansoura Faculty of Medicine, Mansoura, Egypt; Mansoura University Children's Hospital, Mansoura, Egypt (Tel: 00 2050 2230376; Fax: 00 2050 2234092; Email: ashbakr@mans.edu.eg)

Background: Mass urinary screening is a useful way to detect the prevalence of renal diseases and to improve its outcome. This study was undertaken to detect the prevalence of asymptomatic urinary abnormalities among primary school children  in Egypt.

Methods: A total of 1670 healthy children were included in this study. Urinary screening was performed with the dipstick method.

Results: Twenty-two children (1.3%) had urinary abnormalities at the first screening and only 12 (0.72%) had urinary abnormalities at the second screening. Of the children who had urinary abnormalities, 6 (0.36%) had isolated hematuria (IH), 2 (0.12%) had isolated proteinuria (IP) and 4 (0.24%) had combined hematuria and proteinuria (CHP). Renal biopsy was performed on 4 children (2 with CHP, 1 with IH and 1 with IP). Post streptococcal acute glomerulonephritis (PSAGN) was identified in 3 of the 6 IH children, hypercalciuria and renal stone in 2, and no abnormality in 1. One of the IP children had orthostatic proteinuria and the other had focal segmental glomerulosclerosis. The pattern of renal diseases in CHP children was PSAGN in 2, diffuse mesangial proliferation in 1 and IgA nephropathy in 1.

Conclusions: Asymptomatic urinary abnormalities were detected in a small number of primary school children in Egypt and PSAGN was the leading cause for these abnormalities. Only 3 children had evidence of chronic kidney disease. The study raises question about the cost-benefit ratio for the national implementation of the urine screening program.

Key words: urine screening; hematuria; proteinuria; primary school children