The Indian Journal of Pediatrics

, Volume 55, Issue 4, pp 481–494 | Cite as

Screening for renal disease in school children: experience in Japan

  • Teruo Kitagawa
Symposium: Nephrology


A program of urine screening for asymptomatic hematuria and proteinuria in school children has been conducted since 1973 by the Ministry of Education in Japan with great success in the early detection of asymptomatic renal disease. Prevalence of isolated persistent hematuria in school children was approximately 05%. Prevalence of isolated proteinuria and proteinuria with associated hematuria was 0.08% of primary school children and 0.4% of junior high school children. In order to know whether this nationwide program for 13 years causes some changes in the epidemiology of chronic glomerular disease in Japan, a multicenter survey was conducted on the number of patients with renal diseases. 70–80% of IgA and non-IgA mesangial proliferative glomerulonephritis and 65 to 80% of MPGN were detected by mass urine screening at school. Severe glomerular lesions were more frequently observed in children with chance proteinuria and hematuria, as well as IgA and non-IgA mesangial proliferative glomerulo nephritis who have severe proteinuria. Mild glomerular change was more frequent in patients with MPGN, IgA and non-IgA mesangial proliferative nephritis who were detected by our screening program rather than those seen with some of the nephritic signs and symptoms at diagnosis The above evidence appears that screening program may open the way for the early management of these diseases, especially for which treatment is already established.


Urine screening Chance proteinuria/hematuria Asymptomatic hematuria/proteinuria IgA nephrpathy MPGN 


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  1. 1.
    Dodge WF, West EF, Smith EH, Bunce H. Proteinuria and hematuria in school children: Epidemiology and early natural history.J Pediatr 1976; 88: 327–347PubMedCrossRefGoogle Scholar
  2. 2.
    Kitagawa T. Screening for asymptomatic hematuria and proteinuria in school children-Relationship between clinical laboratory findings and glomerular pathology or prognosis.Acta Paediatr Jpn 1985; 27:366–373Google Scholar
  3. 3.
    Kitagawa T. Epidemiology of renal disease in children in Japan-A collaborative, study.Asian Med J 1987;30: 496–504Google Scholar
  4. 4.
    Bashford HH. Some notes on adolescent aihuminuria; incidence, significance and after-history.Lancet 1926; ii: 1305–1307CrossRefGoogle Scholar
  5. 5.
    Hamill SM, Blackfan KD. Frequency and significance of albumin in the urines of normal children.Am J Dis Child 1911; 1: 139–163Google Scholar
  6. 6.
    Sinniah R, Law CH, Pwee HS. Glomerular lesions in patients with asymptomatic persistent and orthostatic proteinuria discovered on routine medical examination.Clin Nephrol 1977; 7:1–14PubMedGoogle Scholar
  7. 7.
    Vehaskari VM, Rapola J. Isolated proteinuria: Analysis of school-age population.J Pediatr 1982;101: 661PubMedCrossRefGoogle Scholar
  8. 8.
    Randolph MF, Greenfield M. Proteinuria.Am J Dis Child 1967; 114: 631–638PubMedGoogle Scholar
  9. 9.
    Wagner MG, Smith FG, Tinglof BO, Comberg E. Epidemiology of proteinuria.J Pediatr 1968; 73:825–832PubMedCrossRefGoogle Scholar
  10. 10.
    Silverberg DS, Allard MJ, Ulan RA, Beamish WE, Lentle BC, McPhee MS, Grace MG. Citywise screening for urinary abnormalities in school girls.Can Med Assoc J 1973; 109: 981–985PubMedGoogle Scholar
  11. ll.
    Sinniah R, Pwee HS, Lim CH. Glomerular lesions in asymptomatic microscopic hematuria discovered on routine medical examination.Clin Nephrol 1976; 5: 216–228PubMedGoogle Scholar
  12. 12.
    Vehaskari VMM, Rapola J, Koskrimies O, Savilahti E, Vilska J, Hallman N. Microscopic hematuria in school children: Epidemiology and clinicopathologic evaluation.J Pediatr 1979; 95: 676–684PubMedCrossRefGoogle Scholar
  13. 13.
    Silverberg DS. City-wide screening for urinary abnormalities in school boys.Can Med Assoc J 1974;111: 410–412PubMedGoogle Scholar
  14. 14.
    Kincaid-Smith P, Nicholls K. Mesangial IgA nephropathy.Am J Kidney Dis 1983; 3: 90–102PubMedGoogle Scholar
  15. 15.
    Kobayashi Y, Tateno S, Hiki Y, Shigematsu H. IgA nephropathy: Prognostic significance of proteinuria.Nephron 1983; 34: 146–153PubMedGoogle Scholar
  16. 16.
    Hattori S, Karashima S, Furuse A, Terashima T, Hiramatsu M, Murakami M, Matsuda I. Clincopathological correlation of IgA nephropathy in children.Am J Nephrol 1985; 5: 182–189PubMedCrossRefGoogle Scholar
  17. 17.
    Clarkson AR, Seymour AE, Thompson AH, Haynes WDG, Chan Y-L, Jackson B. IgA nephropathy: A syndrome of uniform morphology, diverse clinical features and uncertain prognosis.Clin Nephrol 1977; 8: 459–471PubMedGoogle Scholar
  18. 18.
    Levy M, Gonzales-Burchard G, Broyer M, Dommergues JP, Foulard M, Soreg JP, Habib R. Berger’s disease in children, natural history and outcome.Medicine 1985; 64: 157–180PubMedGoogle Scholar
  19. 19.
    McAdams AJ, McEnery PT, West CD. Mesangiocapillary glomerulonephritis; changes in glomerular morphology with longterm alternate-day prednisone therapy.J Pediatr 1975; 86: 23–31PubMedCrossRefGoogle Scholar
  20. 20.
    McEnery PT, McAdams AJ, West CD Membrano-proliferative glomerulonephritis; improved survival with alternate day prednisone therapy.Clin Nephrol 1980; 13: 117–124PubMedGoogle Scholar
  21. 21.
    McEnery PT, McAdams AJ, West CD. The effect of prednisone in a high dose, alternate-day regimen on the natural history of idiopathic membranoproliferative glomerulonephritis.Medicine 1986; 64: 401–424Google Scholar
  22. 22.
    West CD. Childhood membranoproliferative glomerulonephritis: An approach of management.Kidney International 1986; 29: 1077–1093PubMedCrossRefGoogle Scholar
  23. 23.
    West CD, McEnery PT, McAdams AJ. Experience with alternate day prednisone in the management of fourty-five children with membranoproliferative glomerulonephritis (MPGN).Recent advances in pediatric nephrology (Ed. by K. Murakami et al); Amsterdam Excerpta Medica 1987; 81–84Google Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 1988

Authors and Affiliations

  • Teruo Kitagawa
    • 1
  1. 1.Department of Pediatrics, School of MedicineNihon UniversityTokyoJapan

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