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大学生の腎疾患・蛋白尿の病歴調査(その3) : 学校検尿と大学入学後の尿異常パターン

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概要 This paper reports a comparative and longitudinal study of the previous history of the renal diseases and urine abnormalities in the students of Kyushu University. The past history of the renal diseas...es and/or urinary abnormality was previously obtained by the questionnaire at the time of the freshman registration. In case of incomplete or obscure history, the students were interviewed by one of the medical staffs of the Institute of Health Science and detailed medical histories were obtained. These medical histories of the renal diseases were compared with the results of urine examination carried out at the time of the annual health examination. 1). Among 13,438 freshmen and women of Kyushu University during the last 7 years (from 1980 to 1986), the history of the renal diseases and/or urinary abnormalities were found in 1,322 students (9.8%). The incidence of renal diseases was higher than that of 8.6% studied in the previous period from 1975 to 1979 and the persistent increase was observed in the incidence of the renal diseases and/or urinary abnormalities during the last 14 years (6.4% in students during the years from 1972 to 1974; 4.0% during the years from 1967 to 1971) (p<0.01). This was mainly due to the increase of the cases with urinary abnormalities found by urinalyses which had been conducted every year under the guidance of the Ministry of Education based on the revised regulation for the annual school health examinations since 1974. 2). Out of 1,322 students with the history of the renal diseases and/or urinary abnormalities, 800 (60.5%) were the students found at the annual school health examinations. This rate of 60.5% was much higher than that of 44.3% in the previous period of 5 years Institute of Health Science, Kyushu University 11. Kasuga 816, Japan. Second Department of Internal Medicine, University of Occupational and Environmental Health. Kitakyushu 807, Japan. (1975-1979; p<0.01). During the last 7-year period, however, there was no significant, yearly increase in the rate of urinary abnormalities found by the school health examination. 3). Among the diagnoses of the renal diseases in the students, acute glomerular nephritis was found in 187 students (incidence: 13.9/1,000 students; the cases found by the school health examination were included). This was the significant. decrease in the incidence of acute glomerular nephritis compared with that of 20.1/1,000 students (1975-1979) and 25.8/1,000 (1972-1974) during the previous periods (p<0.01) . 4). The analysis of the questionnaire revealed that urinary abnormalities found at the precollege annual health examination were rechecked at the school in 84.0% cases (rechecking rate: 43% during the previous period of 1975-1979). Continued urine abnormalities were found only 21.8% out of 671 students on rechecking. Among the students who visited the hospitals for further evaluation, 50% were found no renal disease or genitourinary abnormality. Renal disease was diagnosed in 111 Students (36%) including acute glomerular nephritis in 24, chronic glomerular nephritis in 24, nephrotic syndrome in 2, and possible chronic glomerular nephritis in 32 students. 5). Urine examination after the entrance to the college demonstrated abnormal findings in 311 out of 1,322 students with the history of the renal diseases and/or urine abnormalitieses (23.5%). When the precollege urine abnormality patterns were compared with the results of the urine examination in the college, isolated proteinuria became negative in 76% and isolated hematuria in 26%, while proteinuria with microhematuria became negative in 67% of the students. These results indicate that, further study to obtain the results of long-term follow-up studies to determine the incidence of progressive renal disease and the ultimate outcome is needed although most of the urine abnormalities in schoolchildren are transient and non-progressive. (Journal of Health Science, Kyushu University, 9: 21-29 1987)続きを見る

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登録日 2009.09.10
更新日 2018.06.12