Clinical and Pathological Analysis of Asymptomatic Hematuria and/or Proteinuria in Children

Objective:To investigate the clinical and renal pathologic features of asymptomatic hematuria and/or proteinuria in children and the relationship between them.Methods:A retrospective review of 323 cases of asymptomatic hematuria and/or proteinuria who had been performed renal biopsy within 10 years (1995 to 2005) were conducted to analyse their clinical manifestations and renal pathologic features.Results:In 323 children with asymptomatic hematuria and/or proteinuria, there were 229 children with isolated hematuria,19 with asymptomatic proteinuria and 75 with asymptomatic hematuria and proteinuria.Among the pathologic changes of their nephridial tissue, minor abnormalities was found in 103 cases(31.89%),normal biopsies in 74 cases(22.91%),IgA nephropathy(IgAN) in 73 cases(22.60%),thin basement membrane nephropathy (TBMN) in 27 cases(8.36%),mesangial proliferative glomerulonephritis(MsPGN) in 18 cases(5.57%),focal proliferative glomerulonephritis(FPGN) in 10 cases(3.10%),membranous nephropathy(MN) in 8 cases(2.48%),focal segmental glomerulosclerosis(FSGS) in 8 cases(2.48%),minimal change(MCD) in 1 case(0.31%) and IgM nephropathy(IgMN) in 1 case(0.31%).The proportion of normal biopsies in the isolated hematuria group was higher than that in the asymptomatic hematuria and proteinuria group(P0.01);the proportion of IgAN in the asymptomatic hematuria and proteinuria group was higher than that in the isolated hematuria group and that in the asymptomatic proteinuria group (P0.01,P0.05 respectively).According to Lee grading,grade Ⅰ and Ⅱ were found in 85% of the IgAN children with isolated hematuria, but in 58.10% of the IgAN children with asymptomatic hematuria and proteinuria,the others were grade Ⅲ or above;there was significant difference between the above two groups(x2=6.47,P0.05).Conclusion:The results support that the main pathologic changes of asymptomatic hematuria and/or proteinuria in children are minor abnormalities, normal and IgAN;and the pathogenetic changes in asymptomatic hematuria and proteinuria group is more serious than that in isolated hematuria group.