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Follow-up of children with isolated microscopic hematuria detected in a mass school urine screening test

Korean Journal of Pediatrics 2006;49(1):82-86.
Published online January 15, 2006.
Follow-up of children with isolated microscopic hematuria detected in a mass school urine screening test
Mi-sun Yum1, Hoe Soo Yoon1, Joo Hoon Lee1, Hyewon Hahn2, Young Seo Park1
1Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine
2Department of Pediatrics, School of Medicine, Eulji University, Seoul, Korea
학교집단소변검사에서 발견된 단독 현미경적 혈뇨의 추적 관찰
염미선1, 윤회수1, 이수훈1, 한혜원2, 박영서1
1울산대학교 의과대학 서울아산병원 소아과
2을지의과대학교 소아과학교실
Young Seo Park, Email: yspark@amc.seoul.co.kr
: The isolated microscopic hematuria is the most common abnormality detected by school urinary screening, but there is no consensus about the range of investigations and long-term outcomes of isolated hematuria in children yet. This study aims to elucidate the prognosis of hematuria and the range of diagnostic studies by follow-up results.
: Students with isolated hematuria who were referred to the Department of Pediatrics, Asan Medical Center from Aug. 1990 to Feb. 2004 were analysed retrospectively. Cases that presented Through significant proteinuria(>250 mg/day), other symptoms of nephritis or renal dysfunction (creatinine clearance <85 mL/min/1.73m2) were excluded. Follow-up was done every six months with checking urinalysis, serum creatinine, protein and albumin. When albuminuria was detected, 24 hour urine protein was checked. Renal biopsy was done when urine protein was over 500 mg/day.
: A total of 331 students were enrolled in this study. There were 157 males and 174 females. The mean age at presentation was 9.9?.3 years(7-15 years) and mean follow-up period was 2.2?.6 years(1-10 years). Seventy five(22.7 percent) patients showed the resolution of microscopic hematuria. The mean resolution period was 2.6?.7 years(1-8 years). Eight(2.4 percent) patients developed significant proteinuria and renal biopsy was done in four of them. Two cases of mild IgA nephropathy and two of minimal change were detected. None of them developed hypertension. At the end of the follow-up, renal function had remained stable in all subsets of patients.
: The prognosis of isolated microscopic hematuria was good. This study suggests that invasive studies including renal biopsy are not necessary and a regular follow-up of urinalysis is enough for children with isolated microscopic hematuria.
Key Words: Isolated microscopic hematuria , Children , School urine screening

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