Analysis of Isolated Proteinuria on School Urinary Mass Screening Test in Busan and Kyungsangnam-do Province

Oh, Dong Hwan; Kim, Jung Soo; Park, Ji Kyoung; Chung, Woo Yeong

Abstract

PURPOSE: The urinary mass screening program for the detection of urinary abnormalities in school aged population has been performed in Seoul since 1981. Nation-wide urinary mass screening program was also performed since 1998. The aim of this study was to analyze the cause and nature of isolated proteinuria detected by chance on the urinary mass screening test in Busan and Kyungsangnam-do Province.
METHODS
The medical records of 44 cases of isolated proteinuria detected by chance on the urinary mass screening test in Busan and Kyungsangnam-do Province, and evaluated for urinary abnormalities at the pediatrics outpatients renal clinics of Busan Paik Hospital from April 2002 to August 2003 were reviewed prospectively.
RESULTS
The cause and incidence of isolated proteinuria were as follows; transient proteinuria 4 cases(9.1%), orthostatic proteinuria 36 cases(81.8%) and persistent proteinuria 4 cases (9.1%). The total protein amount of the 24 hour urine were 121.0+/-136.4 mg in transient proteinuria, 179.1+/-130.0 mg in orthostatic proteinuria and 1532.8+/-982.5 mg in persistent proteinuria. In the orthostatic proteinuria group, the total protein amount of the 24 hour urine was in the range of 40-616 mg. Spot urine protein/creatinine ratio(PCR) were 0.10+/-0.01 in transient proteinuria, 0.61+/-0.61 in orthostatic proteinuria and 4.35+/-4.04 in persistent proteinuria. In the orthostatic proteinuria group, spot urine PCR was in the range of 0.09-2.32. Renal biopsy was performed in 4 children of the persisitent proteinuria group. They showed minimal change in 1 case, membranoproliferative glomerulonephritis in 2 cases and secondary renal amyloidosis in 1 case.
CONCLUSION
The majority of isolated proteinuria which was detected by chance on school urinary mass screening were transient or orthostatic proteinuria. Even though the incidence of persistent proteinuria was much lower, it is necessary to take care of these children regularly and continuously, because persistent proteinuria itself is a useful marker of the progressive renal problems.