Abstract:

Objective To investigate the incidence of kidney diseases for children in Qidong, evaluate the efficacy of early screening and intervention, and explore a feasible early screening model for pediatric chronic kidney diseases (CKD). Methods A prospective cohort was established, and children (0-1 year old) born in 2022 who underwent child health examinations at Qidong Women’s and Children’s Health Hospital were enrolled. Dual screening (urinary system ultrasound and urine dipstick screening) was performed. Infants with abnormal results in initial urine dipstick were repeat screened, and those with abnormalities found in the ultrasound screening were followed up. The questionnaire was used to assess parental awareness of pediatric kidney diseases, and the association between parents’ educational level and the awareness were analyzed using the Chi-square test. Results A total of 1 988 infants were included, with a median age of 1.10 (0.73-3.20) months, including 988 boys (49.7%). Ultrasound screening was completed for 1958 individuals (98.5%), and 231 abnormal cases (11.8%) were detected. Among them, 195 cases (10.0%) were congenital anomalies of the kidney and urinary tract, primarily isolated renal pelvis dilation (140 mild, 9 moderate, and 2 severe cases), followed by duplex kidney or duplicated renal pelvis, unilateral small kidney or bilateral kidneys of unequal size, renal cysts, and distal ureteral cysts. Additionally, 25 cases of renal crystal and 10 cases of increased echogenicity of both kidneys were detected. A total of 1933 individuals (97.2%) completed urine dipstick screening. Abnormalities were detected in 180 cases (9.3%) during the initial screening, with increased white blood cells in urine being the most common. The abnormal rate of re-screening was 0.5%. A total of 1903 infants completed dual screening. Among them, 17 cases (0.89%) had abnormal results in both screenings. A total of 1809 parental questionnaires on pediatric kidney diseases awareness were collected (response rate 91.0%), with an awareness rate of 11.2%. Parents with an educational level of college or above had a significantly higher awareness rate compared to those with lower education levels (P<0.05). Two cases of severe hydronephrosis were identified through early screening and were promptly treated with surgical intervention, with favorable prognoses achieved. Conclusions Early postnatal urinary system ultrasound and urine dipstick screening facilitate the early detection of pediatric kidney diseases, providing a crucial evidence for timely and effective clinical intervention.

Key words: urinary system ultrasound screening, urine dipstick screening, chronic kidney disease, infant