Epidemiology and Risks of Red Urine in Patients in the Pediatric Emergency Department of a Medical Center in Central Taiwan: An 8-Year Study

兒科急診中赤尿患者的流行病學和風險：中台灣一所醫學中心的8年的研究

高峻凱(Jun-Kai Kao) ； 李一賢(I-Hsien Lee) ； 黃靜宜(Chin-Yih Huang) ； 曹龍彥(Lon-Yen Tsao)

《中山醫學雜誌》 22卷4期 (2011/12) Pp. 409-416

https://doi.org/10.30096/CSMJ.201112.0002

摘要

背景：紅色尿在兒科急診室的病童中是一項少見的主訴，赤尿的原因可分成血尿及非血尿。造成非血尿的赤尿有許多的原因且兒童血尿的成因不同於成年的患者。腎絲球的病變若沒有即早發現或治療可能會造成腎衰竭的情形，因此為了研究有關兒童赤尿患者的流行病學和腎絲球腎炎的風險，我們進行了一個回顧性研究，分析了從2000年6月至2007年6月間以紅色尿液為主訴來到彰化基督教醫院兒童急診求診的病患。方法：以描述性統計、two-sample t test和Pearson product-moment correlation coefficient回顧分析了180份相關病歷。結果：兒童急診求診的病患中，紅色尿的盛行率為0.9／1,000。血尿和非血尿病童的年齡在統計上有顯著差異（6.10±3.37SD vs. 3.06±3.35SD）。泌尿道感染是最常見的原因（36.7%）。約有10.2%的病童有腎絲球腎炎。赤尿的兒童中，腎絲球腎炎患者的血中C-reactive蛋白較非腎絲球腎炎患者高且接近統計上有意義的差異。而反覆赤尿的病史與蛋白尿則與腎絲球腎炎有顯著的相關性。結論：赤尿為主訴的患者在兒童急診是不常見的狀況（0.9／1000）。約有10.2%的赤尿兒童有腎絲球腎炎。病史中有反覆赤尿或是蛋白尿的患者有較高的腎病風險。

關鍵字

紅尿 ； 血尿 ； 腎絲球腎炎 ； 蛋白尿 ； 兒童急診

並列摘要

Background: Red urine, an uncommon presentation in the pediatric emergency room, can be categorized into pigmenturuia and gross hematuria. Pigmenturia has been associated with a number of conditions, including colored foods and crystals. However, gross hematuria results from different causes and presents different risks in adults than in children. Glomerulopathies, the incomplete clearing of substances from the blood that make their way through the glomerulus to urine, can progress to end-stage renal failure if not detected and treated early. Therefore, this study undertook a retrospective analysis of all pediatric patients who presented red urine at the pediatric emergency department of Changhua Christian Hospital between June 2000 and June 2007 to determine the proportion of red urine, analyze probable etiologies and investigate the factors associated with the development of glomerulonephritis in this population.Methods: We reviewed and analyzed 180 medical charts of children with red urine and tested our results using two-sample t-test and Pearson product-moment correlation coefficient.Results: Almost 1/1000 (0.9/1,000) children visiting the pediatric emergency room presented red urine during the study period. Gross hematuria and pigmenturia patients were significantly different in age (6.10 ±3.37SD vs. 3.06 ±3.35SD, respectively; p=＜0.001. The most common underlying cause was urinary tract infection (36.7%). Glomerulonephritis occurred in 10.2% of all the patients. There was a significant difference in C-reactive protein concentrations in glomerulonephritis patients and non-glomerulonephritis patients. Cases with recurring red urine and proteinuria were significantly more likely to have glomerulonephritis.Conclusion: Red urine is relatively uncommon (0.9/1,000) in children visiting the emergency room. Glomerulonephritis was found in 10.2% of patients presenting with red urine. Patients with red urine who had a history of recurrence or proteinuria were a greater risk of glomerulonephritis.

並列關鍵字

red urine ； gross hematuria ； glomerulonephritis ； proteinuria ； pediatric emergency