RENAL TRACT ABNORMALITIES DETECTED IN AUSTRALIAN PRESCHOOL-CHILDREN

Objective: To quantify the incidence of abnormalities in urinalysis an d blood pressure from preschool children and their predictive value in detecting renal disease within an Australian community. Methodology: Urine samples, blood pressure and height measurements and parental rep orts of significant medical problems were collected from a total of 93 55 South Australian preschool children. Seven hundred and forty-three children with abnormal results were investigated in a nephrology outpa tient clinic. A control group of 357 children with no detectable abnor mality were also recalled, examined and, where appropriate, investigat ed. Results: Nine thousand, three hundred and fifty-five children were tested. Of these, 0.81% were shown to have a clinically significant r enal tract abnormality. The findings included children with urinary tr act infections, vesico-ureteric reflux, glomerular disease, renal calc uli, essential hypertension and a renal neoplasm. While dipstick-based methods were the most specific indicators of renal tract abnormalitie s, measurement of blood pressure and urinary beta(2)-microglobulin wer e also important in detecting abnormalities. Screening for glycosuria did not result in the detection of significant undiagnosed abnormaliti es. In the control group with no abnormality detected at testing, ther e was one case each of aortic coarctation, polycystic kidney disease a nd vesico-ureteric reflux diagnosed. Conclusion: Undiagnosed renal tra ct abnormalities are present in many Australian preschool children. Mo st are detectable by a thorough history, examination and urinalysis.