Among children diagnosed with type I membranoproliferative glomerulonephritis by the screening program, no child developed ESRD. Furthermore, among the children who have been undergoing the annual school-screening program, the age at which ESRD developed has been increasing. Thus, urinary screening would not only help in early detection, but consequently also

with preventing the deterioration of renal function later in life. However, controversy about the usefulness of screening still exists, particularly regarding the cost-effectiveness of screening asymptomatic subjects. Bibliography 1. Murakami M, et al. Pediatr Nephrol. 1991;5:50–3. Selleckchem Ulixertinib (Level 4)   2. Murakami M, et al. Kidney Int. 2005;94(Suppl):S23–7. (Level 4)   3. Kamei K, et al. Clin J Am Soc Nephrol. 2011;6:1301–7. (Level 2)   4. Yanagihara T, et al. Pediatr Nephrol. 2005;20:585–90. (Level 4)   5. Cho BS, et al. Pediatr Sirolimus datasheet Nephrol. 2001;16:1126–8. (Level 4)   6. Lee YM, et al. Acta Paediatr.

2006;95:849–53. (Level 4)   7. Park YH, et al. Pediatr Nephrol. 2005;20:1126–30. (Level 4)   8. Lin CY, et al. Pediatr Nephrol. 2001;16:232–37. (Level 4)   9. Yamagata K, et al. Am J Kidney Dis. 2004;43:433–43. (Level 4)   Is hematuria useful for detecting CKD in children? Asymptomatic isolated microscopic hematuria is the most common presentation of microscopic hematuria, and most pediatric Japanese patients are discovered using the urinary screening program. This disease is usually transient and does not require treatment. Asymptomatic isolated microscopic hematuria is present in 0.75–0.98 % of school-aged children in Japan. The most common causes of persistent microscopic hematuria include glomerulopathies, hypercalciuria, and the nutcracker syndrome. Glomerulopathies include IgA nephropathy, hereditary nephritis (Alport syndrome),

and thin basement membrane nephropathy. Lupus nephritis is often associated with severe glomerular PRKACG damage even with asymptomatic microscopic hematuria. CAKUT, the most common cause of ESRD in children, is also associated with microscopic hematuria. Thus, microscopic hematuria should always be considered as a potential underlying symptom of these critical kidney diseases. The relative incidence of the known causes of gross hematuria in children varies depending upon the clinical setting. In a pediatric emergency room, a urinary tract infection, either documented or suspected, was diagnosed in half of the patients with gross hematuria. Other causes included urethral irritation (11 %), trauma (7 %), and acute nephritis (4 %). In a pediatric urology referral service, the causes of gross hematuria and their frequencies included urethral irritation or trauma (15 %), urinary tract infection (14 %), underlying congenital anomalies (13 %), nephrolithiasis (5 %), and malignancy (1 %). There were no cases of glomerular disease.