Screening of renal diseases by urine analysis in primary school aged children at El-Gharbiya governorate-Egypt

Background: Renal diseases are increasingly common causes of childhood morbidity and mortality. Some of these diseases, if undetected and not treated early lead to debilitating chronic disease. Urinary tract infection are common in childhood ,may be subclinical or present with non specific symptoms and signs and have the potential for long term complication. Objective: to assess the urine examination findings among a group of apparently healthy primary school aged Egyptian children between 5 and 12 years old and to ascertain the magnitude of renal diseases among them. Methodology: a cross-sectional study carried out on 706 (333boys & 373 girls) school aged children at primary school at El-Gharbiya governorate Egypt. A stratified random sample was selected from the students. All students enrolled in this study were subjected to complete clinical examination and a urine sample was taken and tested by using a urine dipstick test for protein, blood, glucose, nitrite and leukocyte in urine. Those students with persistent abnormal results with the 2nd urine dipstick test (after 15 days from 1st one) were examined by complete microscopic analysis, urine culture with antibiotic sensitivity for those with positive pus cells. Results: with the initial urine dipstick test, we found 116 students (16.4%) of 706 (53 boys & 63 girls) they had abnormal urinary findings. Second dipstick test done for students with positive findings and revealed that 55 (7.8%) of 706 (26 boys & 29 girls) had abnormal urinary findings, followed by microscopic urine analysis that revealed that 35 (4.96%) students had abnormal urinary findings .Urine culture was done for 24 (3.4%) students that had urinary tract infection, 13 students were positive for E-coli and 3 were positive for staphylococci while 8 showed no growth. Abdominal ultrasound was done for the 35 students with urinary abnormalities by microscopic urine analysis ,it showed 3 (0.42%) students of 706 had a positive findings (2 of them had cystitis and another case had bilateral renal gravels).Conclusion: Urine abnormalities are a common finding among apparently healthy school aged children with pyouria and heamaturia[ were the most prevailing abnormalities]. Recommendation: Urine analysis must be done for school children as a part of routine medical examination at the point of school entry and repeated as a screening for renal diseases at a relatively low cost providing a framework for further follow up that may help in the prevention and timely diagnosis of those with underlying renal diseases.