Screening for renal disease in school children: experience in Japan

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.