ABSTRACT
Introduction: This article reviews published literature on the usefulness of population-based urinary screening in the Asian paediatric population. Methods: Articles were found in the Medline database using the key words “paediatrics”, “urine screening”, “proteinuria”, “haematuria” and “population”. The Asian countries which had carried out population-based urinary screening of the paediatric population included Taiwan, Japan and Korea. One study was found on urinary screening in a select population in Malaysia. Preliminary results of the urinary screening of school children in Singapore are presented and compared with the results found in the above-mentioned countries. Results: Overall, the proportion of children found to have urinary abnormalities ranged from less than 0.1% of the population screened to almost 50% of a select cohort referred from the screening programmes for the evaluation of urinary abnormalities. In the pilot Singapore school screening programme, the prevalence of clinically significant proteinuria was 1.25 per 1000 children screened. Multivariate analysis showed that low body weight was associated with a 1.8-fold greater risk for proteinuria. The major cause of haematuria and proteinuria in those studies where renal biopsies were performed was glomerulonephritis. The Taiwanese experience also showed a reduction in the incidence of end-stage renal failure diagnosed in children after the onset of urine screening. Conclusion: These studies showed that urinary screening programmes in school children allow the early detection of disease. The cost-benefit ratio for specific populations should be determined before the implementation of such programmes.
Singapore has an estimated annual incidence of end-stage renal disease (ESRD) of 158 per million population.1 However, the number of children who develop renal failure, and requiring renal replacement therapy, is relatively low compared to adults. The incidence of ESRD in children ranges from 5 to 6 per million children under the age of 15 years in Europe, Australia and Japan, to 10 to 11 per million children in the United States. In Singapore, with an estimated mid-year population of 4.18 million in 2003, of whom 715,000 were under the age of 15 years, the estimated incidence of ESRD is similar to that in the developed countries at 5 to 6 per million children per year.
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