National Health Survey on the prevalence of urinary abnormalities in the population: then and now (1975 to 2012).

INTRODUCTION This paper presents the results of a community survey on urinary abnormalities which covered 1/80th of the population of Singapore in 1975. These findings were compared with the data from the Singapore National Service Registrants in 1974 as well as data from a recent survey in Singapore and that of other Asian and Western countries. MATERIALS AND METHODS The study covered 18,000 persons aged 15 years and above, representing a sampling fraction of 1/80th of the population. A total of 16,808 respondents attended the field examination centres, of whom 16,497 had their urine sample tested representing 92.7% of the sample population. RESULTS In the dipstick urine testing at the field examination centres, 769 subjects (4.6%) were found to have urinary abnormalities. Two hundred and eighty-two (36.7%) of these 769 subjects were found to have urinary abnormalities based on urine microscopy constituting a prevalence of 1.71%. The prevalence of proteinuria was 0.63% and for both haematuria and proteinuria was 0.73%. The prevalence for hypertension was 0.43% and renal insufficiency was 0.1%. DISCUSSION The consensus is that routine screening for chronic kidney disease (CKD) in the general population is not cost effective as the yield is too low. Whilst, most studies showed that screening of the general population was not cost effective, it has been suggested that screening for targeted groups of subjects could help to identify certain risk groups who may benefit from early intervention to prevent or retard the progression of CKD. CONCLUSION The prevalence of urinary abnormalities in Singapore has remained the same, now and three decades ago.

[1]  M. Mani Prevention of chronic renal failure at the community level. , 2003, Kidney international. Supplement.

[2]  T. Mathew,et al.  Review article: Early detection of chronic kidney disease in Australia: Which way to go? , 2009, Nephrology.

[3]  S. Yusuf,et al.  Albuminuria and risk of cardiovascular events, death, and heart failure in diabetic and nondiabetic individuals. , 2001, JAMA.

[4]  T. Kitagawa Lessons learned from the Japanese nephritis screening study , 1988, Pediatric Nephrology.

[5]  B. C. Kwan,et al.  Prevalence of silent kidney disease in Hong Kong: the screening for Hong Kong Asymptomatic Renal Population and Evaluation (SHARE) program. , 2005, Kidney international. Supplement.

[6]  W. McClellan,et al.  Taking a public health approach to the prevention of end-stage renal disease: the NKF Singapore Program. , 2003, Kidney international. Supplement.

[7]  J. Wetzels,et al.  Macroalbuminuria is a better risk marker than low estimated GFR to identify individuals at risk for accelerated GFR loss in population screening. , 2006, Journal of the American Society of Nephrology : JASN.

[8]  P. Albertsen Screening for Proteinuria in US Adults: A Cost-Effectiveness Analysis , 2004 .

[9]  J. P. O’Hare,et al.  Prevalence of microalbuminuria and hypertension in South Asians and white Europeans with type 2 diabetes: a report from the United Kingdom Asian Diabetes Study (UKADS) , 2006, Diabetes & vascular disease research.

[10]  Burden of CKD, proteinuria, and cardiovascular risk among Chinese, Mongolian, and Nepalese participants in the International Society of Nephrology screening programs. , 2010, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[11]  K. Iseki,et al.  Chronic kidney disease perspectives in Japan and the importance of urinalysis screening , 2008, Clinical and Experimental Nephrology.

[12]  P. Tan,et al.  The changing pattern of glomerulonephritis in Singapore over the past two decades. , 1999, Clinical nephrology.

[13]  K. Chia,et al.  Role of urinary screening programmes in children in the prevention of chronic kidney disease. , 2005, Annals of the Academy of Medicine, Singapore.

[14]  V. Jha,et al.  Asian chronic kidney disease best practice recommendations: Positional statements for early detection of chronic kidney disease from Asian Forum for Chronic Kidney Disease Initiatives (AFCKDI) , 2011, Nephrology.

[15]  Suhardjono,et al.  Detection and prevention of chronic kidney disease in Indonesia: Initial community screening , 2009, Nephrology.

[16]  Fang Wang,et al.  Community-based screening for chronic kidney disease among populations older than 40 years in Beijing. , 2007, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[17]  P. Tan,et al.  The changing pattern of primary glomerulonephritis in Singapore and other countries over the past 3 decades. , 2010, Clinical nephrology.

[18]  J. Kirkpatrick Albuminuria and Risk of Cardiovascular Events , Death , and Heart Failure in Diabetic and Nondiabetic Individuals , 2002 .