Analysis Of Screening Results For Urinary Diseases In Children Related With Problematic Milk Powder

Objective: The urolithiasis is urinary system stone, the stone is different in size, number, composition, and shape, they exist in urinary tract from renal papilla to urethral orifice. They can cause clinical symptoms, for example pain, hematuria and so on[1]. The urolithiasis is clinical common disease. According to the different positions, the urolithiasis is divided into renal calculi, ureteral calculi, bladder calculi and urethral calculi. The former two calculi called upper urinary calculi, the latter two calculi called lower urinary calculi. The morbidity, the stone ingredient, the location as well as age distribution of urinary system stone have remarkable difference in various areas and time [2]. The vast differences in geographic might be associated with climate, diet and socio-economic[3]. In brief, the morbidity of urinary system calculi in children is lower than in adult[4]. Because our country has not established urolithiasis screening system or disease monitor system, we are still lack of population-based information on the prevalence of urolithiasis. At present, the domestic cases of urolithiasis in children were mostly reported in Xinjiang[5]. the large sample epidemiological of the relevant reports is not yet sees. In September 2008, a large number of infants and young children suffering from urinary stones in China, showing mass state, and the children were ever fed melamine-contaminated milk powder, This event attracted widespread attention at home and abroad[6]. From 2004 to 2007, it was found that melamine was let in pet cats and dogs feed, there are reports on melamine in animal[7]. The impacts of melamine on the human body have very little knowledge. September 11, 2008, The People's Republic of China Ministry of Health and the Chinese Medical Association has developed "the consumption of contaminated Sanlu infant formula milk powder for infants and young children related to urinary tract treatment program"[6], In a nationwide, a free screening campaign was developed for urinary system stones related to problematic milk powder. The Second Hospital of Hebei Medical University has been designated as the screening hospital. On September 13, 2008, we launched the screening work. At the same time, we forward-looking design"the questionnaire screening for urinary tract stones, related to the consumption of melamine contaminated milk powder for children " (short questionnaire), In order to complete the diagnosis and treatment of urinary system diseases such as urolithiasis related with the problematic milk powder. We want to investigate and analysis the relationship between the consumption of polluted milk powder and urinary diseases such as stone. We also want to explore the epidemiological and clinical characteristics of urinary tract stones in children, related to problematic milk powder. In this screening process, we also unexpectedly found some of the hydronephrosis and urinary system congenital malformation. Whether the hydronephrosis and urinary system congenital malformation is associated with urinary tract stones, we investigated screening results.Method: For 0~14-year-old children who had eaten problematic milk powder, through their parents fill out questionnaires, physical examination, urine routine, B-urinary system, renal function, liver function and other urine biochemical indexes, we would screen for urinary diseases in children. The children who have urolithiasis and meet the hospital standard, were taken hospitalization, below the standards to follow up. Children who were followed up to give out the suspicious milk powder, alkaline urine, encourage drinking more water, we periodically review their urine routine and urinary system ultrasound inspection. The morbidity of urolithiasis was analyzed in different age group including less than 1year old group, - 2 years old group, - 3 years old group, - 6 years old group and - 14 years old group. According to the period of feeding problematic milk powder, the children were divided into four groups: less than 6 months groups, ~ 12 months groups ~ 24 months groups, and more than 24 months groups. To Analysis the effect of sex, age and feeding period on urinary system stones and the prognosis of related diseases. Whether the hydronephrosis and urinary system congenital malformation is associated with urinary tract stones, we investigated screening results.Results: 9423 of Children were received free screening, of which 58 males and 32 females, male: female was about 1.8:1;①morbidity of urinary stones: stones 90/9423(1.0%), suspicious stones 270/9423 (2.8%);②sex distribution of urinary stones: boys in 58 cases (1.1%), girls in 32 cases (0.8%);③age distribution of urinary stones:≤1-year-old group of 16 cases (1.0%), ~ 2-year-old group of 21 cases (0.9%), ~ 3-year-old group of 39 cases (1.5%), ~ 6-year-old group of 9 cases ( 0.4%), ~ 14 -year-old group of 5 cases (0.5%);④relationship between feeding period and morbidity of urinary stones: feeding period≤6months, morbidity of urinary stones was 0.7%. 6~12 months was 1.5%; 12~24 months was 0.6%; 24~36 month was 0.7%;⑤position distribution of urinary stones: 69 cases of single said renal calculi, 12 cases of both side renal calculi, 6 cases of single said ureteral stones, 2 cases of both side ureteral stones, 1 case of bladder stone;⑥morbidity of hydronephrosis: 48/9423 cases (0.5%) hydronephrosis, 35 cases (0.67%) of boys; 13 cases (0.31%) of girls, 27 cases (0.29%) of left hydronephrosis, 14 cases (0.15%) of right hydronephrosis, 7 cases (0.07%) of bilateral hydronephrosis.⑦137 cases (1.46%) of congenital urinary system malformation.Conclusion: Melamine-contaminated milk powder was associated with urinary tract stones in children. The morbidity of urolithiasis might not be associated with sex, but might be associated with age and feeding period.≤3 years of age group was significantly higher than other age groups in the morbidity of urinary tract stones. Feeding period of 6 to 12 months, the morbidity of urinary tract stones was highest. The incidence of unilateral kidney stones was higher than that of bilateral kidney stones. The forming time of Urinary stone is short and the structure is loose, so the stone can be presented without clinical presentation. Medical treatment was most effective. There are no exact relationship between urinary tract malformations and melamine-tainted milk powder. A large quantity of water and no change in the follow-up have highly incidence of urinary tract abnormalities, they are should be exanimate as soon as possible avoiding delay in diagnosis and treatment. Fetal renal pelvis with mild or moderate expansion, post-natal ultrasound screening of children with renal ureteral review is an effective way to lesions that can make this part of the very early diagnosis and treatment of children.