All issues > Volume 49(1); 2006

Original Article

Korean J Pediatr. 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 MS Yum¹, Hoe Soo HS Yoon¹, Joo Hoon JH Lee¹, Hyewon HW Hahn², Young Seo YS Park¹

¹Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine
²Department of Pediatrics, School of Medicine, Eulji University, Seoul, Korea

Correspondence Young Seo YS Park ,Email: yspark@amc.seoul.co.kr

Abstract

Purpose
: 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.
Methods
: 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.
Results
: 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.
Conclusion
: 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.

Keywords :Isolated microscopic hematuria , Children , School urine screening