Clinical Research: Screening of asymptomatic Indian school children for urinary abnormalities

Name: Prabha Senguttuvan

Hospital / Affiliation: Dr. Mehta’s Children Hospital

Home Country: India

Host Country: India

Year: 2011

Status of your program: COMPLETED

Title of the project: 

Screening of asymptomatic Indian school children for urinary abnormalities  

Topic: 

Chronic Kidney Disease

Short description of the project or abstract:
Introduction: Chronic kidney disease (CKD) is a worldwide public health problem. Globally, CKD is the 12th cause of death and the 17th cause of disability.The importance of CKD and its risk factors have to be realized. Screening programmes with simple urinary tests for proteinuria and hematuria will provide valuable data regarding prevalence of covert renal disease in the community.
Aim: To determine the prevalence of asymptomatic proteinuria and hematuria in school children and to determine their prevalence among boys and girls.
Methods: It is a descriptive prospective cross sectional study done to identify the risk factors such as proteinuria and hematuria in asymptomatic school children in a rural area in Tamil Nadu, India. Both boys and girls aged 10 -15 years studying in a rural school of Tamil Nadu were recruited. Their weight BMI,and blood pressure were noted. Urinalysis was done at the school premises instantly after dipping the urine strips in urine for one second by the investigator and was visually read. Proteinuria was positive if dipstick showed 2+ and above. Hematuria was positive if 2+ or more RBCs were noted. Only positive cases were rechecked after 4 weeks. Descriptive and inferential statistics were done.

Results: A total of 2400 children were recruited. 57.38% of the children had normal BMI, 22.63% were underweight , 14.58% were overweight and 5.42% were obese.91.63% of children had normal blood pressure. Prehypertension was seen in 62(2.58%) (systolic)and18(0.75%)(diastolic)children stage I hypertension, was seen in 40(1.67%)(systolic) and 47(1.96%)(diastolic) children. Only a small group had stage – II hypertension 12(0.50%)(systolic) and 22(0.92%)(diastolic ) But none of these children had urinary abnormalities. 430(17.8%) children had urinary abnormalities at initial visit and dropped to 158 (6.5%) after four weeks. 210(8.75%) had proteinuria at the initial examination and it reduced to 90 (3.5%) when re examined after four weeks. Hematuria was found in 124(5.16%) which reduced to 34 (1.3%) and both were seen in 96 (4%) and after 4 weeks it was 34 (1.2%) Proteinuria and hematuria was more in boys between the age of 13-15yrs and hematuria was rising in females as the age increased. The Data pertaining to prevalence of covert renal disease among asymptomatic school children revealed that overall prevalence of urinary abnormalities were 0.632/1000. Proteinuria was 0.36/1000 , hematuria and combined hematuria and proteinuria was 0.136/1000 each . Proteinuria in males was 0.192% , and in females was 0.168% . In respect to hematuria, the prevalence was 0.104% in males and 0.032% in females . The prevalence of combined Proteinuria & Hematuria was 0.088% in males and 0.048% in females . Prevalence of total positive urinary abnormalities were158( 6.5%)

Learning or Research objectives:

• Prevalence of total positive urinary abnormalities were 6.5%
• Urine screening should be made mandatory in school health check up
• Closer communication with the parents and pediatricians of these children be should be maintained