الفهرس 
Urine Analysis
Chemical examinationOnly 14 pages are availabe for public view
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Abstract
The major health consequences of chronic kidney diseases (CKD)
include not only progression to kidney failure but also an increased risk
of cardiovascular diseases.
To reduce the number of patients with both end stage renal diseases
(ESRD) and cardiovascular diseases, effective screening and treatment
methods for CKD should be established.
Urine analysis remains the best device for screening at the present
time and this is the method for which most data are available. Urine is
usually screened for evidence of blood, protein, glucose or bacteria.
Hematuria, proteinuria and/or glucosuria are probably most often related
to renal pathology.
Mass school urine screening programs can detect chronic renal
diseases in early stags. Early recognition and treatment of CKD-related
complications lead to improved growth, development and the quality of
life in children with this chronic condition.
Mass urinary screening helps to determine the prevalence of renal
diseases. American Academy of Pediatrics recommends a screening
dipstick urine analysis at the age of 5 in preschool children. Mass urine
screening program was applied in a number of Asian countries.
Our study was undertaken to detect the prevalence of
asymptomatic urinary abnormalities among primary and preparatory
school students in Elgharbiya governorate, Egypt. 1500 healthy students
were included in this study. They were 735 (49%) boys and 765 (51%)
girls. The age of the students ranged from 7 to 15 years with mean ± SD
of 11.33 ± 2.21.
Urinary screening was performed with the dipstick tests to the
studied students, and they were re-examined again after 2 weeks for those
who showed any abnormalities in the 1st test. 255 students (17%) had
urinary abnormalities in the first screening. Isolated hematuria was found
in 170 students (11.33%), isolated proteinuria in 30 students (2%),
combined hematuria and proteinuria in 10 students (0.66%), glucosuria in
3 students (0.2%), nitrite in 22 students (1.46%) and leukocyturia in 20
students (1.33%).
Of these 255 students only 60 (4%) had persistent urinary
abnormalities in the second test. Isolated hematuria was found in 30
students (2%), isolated proteinuria in 5 students (0.33%), combined
hematuria and proteinuria in 7 students (0.46%), nitrite in 8 students
(0.53%), leuko-cyturia in 7 students (0.46%) and glucosuria in 3 students
(0.2%).
Complete urine examination was performed to 60 students (4%)
with persistent abnormal findings by dipstick test. Only 53 students
(3.5%) had urinary abnormalities.
Among them 25 students (1.6%) had isolated hematuria, none of
them was positive for protein only, 6 students (0.4%) had combined
proteinuria and hematuria, 21 students (1.4%) had pyuria, 48 students
(3.2%) had crystaluria, 3 students (0.2%) were positive for glucose and 7
students (0.46%) were positive for nitrite. None of the students had
bilharziasis or any other parasitic infections.
Urine culture was performed to 21 students (1.4%) with pyuria and
it was positive in 19 of them The causative organisms were G+ve cocci in
10 students (0.66%) and G-ve bacilli in 9 students (0.6%).
Abdominal ultrasound was done for 19 students and 15 students of
them had abnormal results. 13 students had renal gravels, one student had
backpressure and one student had and cystitis.
Measurement of weight and height showed that 3 students (0.2%)
were under weight, and 10 students (0.66%) had short stature according
to physical growth percentile curves. No students had hypertension.
Treatment of urinary tract infections with antibiotics according to
urine culture results, and treatment of crystaluria with effervescent salts
according to the type of crystals was done.
Complete urine examination was done 2 weeks after treatment, 17
students (1.13%) had persistent abnormal findings, among them 4
students (0.26 %) had hematuria, 7 student (0.46%) had pyuria, 3 students
(0.2%) had glucosuria, non of the students had neither nitrite nor
proteinuria and 11 students (0.73%) had crystaluria.
The prevalence of urinary abnormalities among the studied
students detected by complete urine examination was (3.5%). The
positive predictive value (PPV) of the screening test was (88.3%). The
specificity was (99.5%), sensitivity was (92.3%) and Negative predictive
value (NPV) was (90.5%).