Effect of hematuria on the outcome of IgA nephropathy with mild proteinuria

Tanaka, Kayu; Moriyama, Takahito; Iwasaki, Chihiro; Takei, Takashi; Nitta, Kosaku

doi:10.1007/s10157-014-1068-9

Cited by 20 publications

(21 citation statements)

References 16 publications

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“…Although some studies suggested a significant influence of hematuria on the risk of developing ESRD, 6,9,19,20 others could not confirm this finding. [21][22][23][24] However, the robustness of these studies was reduced by the way in which hematuria was evaluated (at the onset of the disease, at the time of renal biopsy, or by cross-sectional studies) without longitudinal data. 23,24 In other studies, urine dipsticks were used, and the magnitude of hematuria was not quantified.…”

Section: Discussionmentioning

confidence: 99%

“…[21][22][23][24] However, the robustness of these studies was reduced by the way in which hematuria was evaluated (at the onset of the disease, at the time of renal biopsy, or by cross-sectional studies) without longitudinal data. 23,24 In other studies, urine dipsticks were used, and the magnitude of hematuria was not quantified. 20 At the end of follow-up, 17.2% of our patients had reached ESRD.…”

Section: Discussionmentioning

confidence: 99%

“…In some of them, patients with hematuria had a worse prognosis, 6,9,19,20 but this result was not confirmed in others. [21][22][23][24] A common shortcoming in these studies was, however, that the analysis of hematuria was performed only at the onset of the disease or some isolated point in the evolution of patients. Likewise, in most studies, the magnitude of hematuria (i.e., the number of red blood cells [RBCs] per microscopic field) was not quantified.…”

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confidence: 99%

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Remission of Hematuria Improves Renal Survival in IgA Nephropathy

Sevillano¹,

Gutiérrez²,

Yuste³

et al. 2017

JASN

121

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Hematuria is a cardinal symptom in IgA nephropathy, but its influence on the risk of disease progression has been scarcely investigated. We followed a cohort of 112 patients with IgA nephropathy for a mean±SEM period of 14±10.2 years, during which clinical and analytic risk factors (including urine sediment examination) were regularly recorded. According to the magnitude of time-averaged hematuria, we classified patients as those with persistent hematuria and those with negative or minimal hematuria. We also classified patients according to the magnitude of time-averaged proteinuria (>0.75 or ≤0.75 g/d). The proportion of patients reaching ESRD or a 50% reduction of renal function was significantly greater among patients with persistent hematuria than patients with minimal or negative hematuria (30.4% and 37.0% versus 10.6% and 15.2%, respectively; =0.01). Multivariable analysis revealed time-averaged hematuria, time-averaged proteinuria, renal function at baseline, and the presence of tubulointerstitial fibrosis on renal biopsy as independent predictors of ESRD. After hematuria disappearance, which occurred in 46% of the patients, the rate of renal function decline changed from -6.45±14.66 to -0.18±2.56 ml/min per 1.73 m per year (=0.001). Patients with time-averaged proteinuria >0.75 g/d had significantly poorer renal survival than those with time-averaged proteinuria ≤0.75 g/d. However, on further classification by time-averaged hematuria, only those patients with time-averaged proteinuria >0.75 g/d and persistent hematuria had significantly worse renal survival than those in the other three groups. In conclusion, remission of hematuria may have a significant favorable effect on IgA nephropathy outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Remission of Hematuria Improves Renal Survival in IgA Nephropathy

Sevillano¹,

Gutiérrez²,

Yuste³

et al. 2017

JASN

121

View full text Add to dashboard Cite

show abstract

“…Most recently, Lin et al showed that microscopic hematuria was associated with increased risk of ESRD in 1,799 patients with stage 3 to 5 nondiabetic CKD. Whereas, there are several reports denying microscopic hematuria as a risk factor of CKD progression in patients with IgA nephropathy [5,6] …”

Section: Discussionmentioning

confidence: 99%

“…Recently, it has been suggested that young persons with persistent isolated microscopic hematuria may indeed have an increased risk for ESRD as compared with individuals without this condition [4]. On the other hand, there are several contradictory results, ruling out the impact of microscopic hematuria on the outcome of IgA nephropathy [5,6]. Therefore, microscopic hematuria has not reached consensus as a risk factor of ESRD [7].…”

Section: Introductionmentioning

confidence: 99%