Renal histological features of school-age children with asymptomatic haematuria and/or proteinuria: a multicenter study

Nephrology (Carlton). 2014 Jul;19(7):426-31. doi: 10.1111/nep.12260.

Abstract

Aim: The risk of asymptomatic haematuria and/or proteinuria development into chronic progressive glomerulonephritis (CPG) is unclear. The indications for renal biopsy and follow-up on these asymptomatic children remain controversial.

Methods: A multicenter, retrospective study was performed to investigate the renal histological features of school-age children with asymptomatic urine abnormalities.

Results: A total of 112 asymptomatic children's renal biopsy data were studied. Most of the children (71%) received a renal biopsy because of isolated microscopic haematuria (IH), and these children were predominantly (60%) proven to have only mild lesions in the glomeruli. Approximately 30% of the children were biopsied because of asymptomatic proteinuria with or without microscopic haematuria (HP or isolated asymptomatic proteinuria (IP)), and these children were mostly (44-83%) indicated to have CPG, such as IgA nephropathy, focal segmental glomerulosclerosis, and Alport syndrome. The junior high school students had a greater percentage of HP than the primary school children. IgA nephropathy was the most common diagnosis in children who received renal biopsy because of HP.

Conclusions: Our findings indicate that IP and especially HP may have a high risk of development into CPG. IH, however, has a relatively low risk of severe histological lesions. Thus, IH per se might not be suggested as an indication for early renal biopsy. Long-term follow-up is necessary for these asymptomatic children.

Keywords: glomerulonephritis; haematuria; proteinuria; renal biopsy; urinalysis.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Asymptomatic Diseases / epidemiology*
  • Biopsy
  • Child
  • China / epidemiology
  • Early Diagnosis
  • Female
  • Glomerulonephritis* / classification
  • Glomerulonephritis* / diagnosis
  • Glomerulonephritis* / epidemiology
  • Glomerulonephritis* / etiology
  • Hematuria* / complications
  • Hematuria* / diagnosis
  • Hematuria* / epidemiology
  • Hematuria* / physiopathology
  • Humans
  • Kidney / pathology
  • Male
  • Prognosis
  • Proteinuria* / complications
  • Proteinuria* / diagnosis
  • Proteinuria* / epidemiology
  • Proteinuria* / physiopathology
  • Retrospective Studies
  • Risk Adjustment