Defining Substantial Renal Pathology in Alternative Military Service Standards

The definition of substantial renal pathology during alternative military service suspension?

I apologize for the inquiry, Dr.
Wu, regarding the standards for alternative military service suspension.
The criteria state "pathological examination of the kidneys shows significant renal lesions." Concerning the definition of significant renal lesions, my company’s health check report from September last year indicated the presence of hematuria 1+ and a glomerular filtration rate (GFR) of 82 ml/min/1.73 m², which required re-examination.
In December last year, the hospital tests showed hematuria 2+, proteinuria, creatinine level of 1.12, and a GFR of 77, indicating stage 2 chronic kidney disease.
The doctor suspects I may have type A globulin nephropathy and recommends further testing.
I would like to ask, Dr.
Wu, does this mean I have significant renal lesions?

Yao Ge, 20~29 year old female. Ask Date: 2014/01/19

Dr. Wu Jiyu reply Internal Medicine

1.
Based on the two reports you provided, which indicate "hematuria + proteinuria" in the urine and a serum creatinine level showing "glomerular filtration rate of 82-77 ml/min/1.7 m²," there is indeed a need to suspect the presence of significant renal pathology.

2.
To further diagnose, it is essential to assess the degree of proteinuria and determine whether a kidney biopsy is necessary for confirmation.

3.
Regarding the standards for alternative military service suspension, "renal pathology examination indicating significant renal disease" refers to findings confirmed by a kidney biopsy, rather than relying solely on urine and blood tests.
Thank you for your inquiry; the Nephrology Department at Changhua Hospital is here to assist you.

Reply Date: 2014/01/19

More Info

Defining substantial renal pathology in the context of alternative military service standards is crucial for understanding eligibility and health implications. In your case, the term "substantial renal pathology" typically refers to significant and identifiable kidney damage or disease that can be confirmed through medical testing, particularly renal biopsy.
Based on the information you provided, your medical history indicates a progression of kidney-related issues. Initially, your company health check revealed hematuria (blood in urine) and a glomerular filtration rate (GFR) of 82 mL/min, which is within the normal range but on the lower side. However, subsequent tests showed increased hematuria (2+), proteinuria (presence of protein in urine), a serum creatinine level of 1.12 mg/dL, and a GFR of 77 mL/min. These findings suggest a decline in kidney function and the presence of kidney disease, specifically chronic kidney disease (CKD) stage 2.

The presence of hematuria and proteinuria, especially in conjunction with a declining GFR, raises concerns for underlying renal pathology. In your case, the suspicion of "IgA nephropathy" (甲型球蛋白腎病變) indicates that your physician is considering a specific type of kidney disease that can lead to further complications if not monitored and treated appropriately.
To determine if you have "substantial renal pathology," a renal biopsy is often required. This procedure allows for direct examination of kidney tissue, which can confirm the presence of specific diseases, such as IgA nephropathy, and assess the extent of damage. The criteria for "substantial renal pathology" in the context of alternative military service typically require evidence from a renal biopsy rather than relying solely on urine and blood tests.
In summary, while your current test results indicate significant kidney issues, the definitive diagnosis of "substantial renal pathology" would require a renal biopsy to confirm the presence of specific kidney disease. If the biopsy confirms a pathological condition, you would likely meet the criteria for alternative military service based on the standards you mentioned.

It is essential to follow up with your healthcare provider regarding the need for further testing, including a renal biopsy, to clarify your diagnosis and guide your treatment plan. Additionally, maintaining regular monitoring of your kidney function and adhering to any prescribed treatments will be crucial in managing your condition effectively.
For anyone in a similar situation, understanding the definitions and implications of renal pathology is vital, not only for military service considerations but also for overall health management. Chronic kidney disease can progress silently, so proactive monitoring and early intervention are key to preserving kidney function and preventing complications.

Similar Q&A

Understanding Minimal Change Disease in Nephrotic Syndrome and Military Exemption

Conditions for various types of nephritis include one of the following: 1. Chronic renal impairment confirmed by examination, with serum creatinine greater than 2 mg/dL and creatinine clearance less than 50 mL/min. 2. Histopathological examination of the kidneys showing significa...

Dr. Lin Wuxuan reply Internal Medicine
Please proactively inform the examining physician and provide your medical history during the military conscription examination, in accordance with the regulations set by the Ministry of National Defense and the Military Service Agency of the Ministry of the Interior. Thank you.

Is Severe Hydronephrosis Leading to Kidney Atrophy a Major Health Concern?

Dear Dr. Pei, I would like to ask you a few questions, and I appreciate you taking the time to respond amidst your busy schedule. When my child was four to five months in utero, severe hydronephrosis was detected in the left kidney, which had enlarged to 4.5 cm. Amniocentesis ...

Dr. Pei Rensheng reply Pediatrics
Hello: 1. According to the regulations on major illnesses from the Department of Health website (http://www.nhi.gov.tw/webdata/AttachFiles/Attach_1059_1_W0940043268衛署941221公告重大傷病範圍表.doc): - Chronic renal failure (uremia) requiring regular dialysis treatment is classified as...

Can Kidney Stones Exempt You from Military Service in Taiwan?

Hello doctor, I recently went to the hospital and was diagnosed with kidney stones on both sides. I would like to know if this condition could exempt me from military service. Thank you.

Dr. Du Shixi reply Urology
Hello: Urinary tract stones are considered a common condition. Only if there is renal dysfunction might there be a possibility of changing military service status. Wishing you good health.

Understanding Kidney Issues: Genetic Concerns and Military Service Implications

Our family has a hereditary disease, so the children's kidneys are not in good condition. I would like to ask the doctor if the small bubbles on my kidneys will have a significant impact. I have not yet served in the military; does this condition require me to enlist? Thank ...

Dr. Chen Jili reply Internal Medicine
1. The presence of bubbles in the kidneys is referred to as cystic kidney. Generally, there are no symptoms in clinical practice, although hematuria may occur. It is recommended to undergo an ultrasound evaluation by a nephrologist. 2. Regarding military service issues, a decisio...