Natural History and Renal Pathology in Patients with Isolated Microscopic Hematuria
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Background/Aims: No definite conclusions have been reached about the natural history of patients with isolated microscopic hematuria (IMH). In this study, we observed the natural history of patients with IMH and examined factors related to a pathologic diagnosis and subsequent prognosis. Methods: We retrospectively evaluated 156 subjects with IMH who had a renal biopsy performed. Of the 156 subjects, 33.3% were diagnosed with IgA nephropathy, 23.7% with mesangial proliferative glomerulonephritis, 15.4% with glomerular minor lesion, and 12.8% with thin basement membrane nephropathy; 6.4% had normal biopsies. Results: We followed up with 100 subjects for about 31 months. During this follow-up period, two subjects who had received a pathologic diagnosis of IgA nephropathy developed chronic kidney disease. During the course of the study, one of these subjects presented with proteinuria and hypertension and the other with proteinuria. The overall incidences of proteinuria and hypertension were 6% and 5% respectively. Conclusions: The prognosis for patients with IMH was relatively favorable, but patients developing proteinuria and/or hypertension require careful observation and management during the follow-up period.
Abstract
Background/Aims: No definite conclusions have been reached about the natural history of patients with isolated microscopic hematuria (IMH). In this study, we observed the natural history of patients with IMH and examinedfactors related to a pathologic diagnosis and subsequent prognosis. Methods: We retrospectively evaluated 156 subjects with IMH who had a renal biopsy performed. Of the 156 subjects, 33.3% were diagnosed with IgA nephropathy, 23.7% with mesangial proliferative glomerulonephritis, 15.4% with glomerular minor lesion, and 12.8% with thin basement membrane nephropathy; 6.4% had normal biopsies. Results: We followed up with 100 subjects for about 31 months. During this follow-up period, two subjects who had received a pathologic diagnosis of IgA nephropathy developed chronic kidney disease. During the course of thestudy, one of these subjects presented with proteinuria and hypertension and the other with proteinuria. The overall incidences of proteinuria and hypertension were 6% and 5% respectively. Conclusions: The prognosis for patients with IMH was relatively favorable, but patients developing proteinuria and/or hypertension require careful observation and management during the follow-up period.
참고문헌 (25)
- Yamagata K, "Prognosis of asymptomatic hematuria and", or proteinuria in men: high prevalence of IgA nephropathy among proteinuric patients found in mass screening, 2002, pp.91, 34~42
- Nieuwhof C, "A prospective study of the natural history of idiopathic non-proteinuric hematuria", Kidney Int, 49, pp.222~225 (1996)
- Topham PS, "Glomerular disease as a cause of isolated microscopic haematuria", Q J Med, 87, pp.329~335 (1994)
- Shen P, "Useful indicators for performing renal biopsy in adult patients with isolated microscopic haematuria", Int J Clin Pract, 61, pp.789~794 (2007)
- Chow KM, "Asymptomatic isolated microscopic haematuria: long-term follow-up", QJM, 97, pp.739~745 (2004)
- Yamagata K, "A long-term follow-up study of asymptomatic hematuria and", or proteinuria in adults, 1996, pp.45, 281~288
- Tiebosch AT, "Epidemiology of idiopathic glomerular disease: a prospective study", Kidney Int, 32, pp.112~116 (1987)
- Shen P, "Natural history and prognostic factors of IgA nephropathy presented with isolated microscopic hematuria in Chinese patients", Nephron Clin Pract, 106, pp.c157~c161 (2007)
- Rauta V, "Factors associated with progression of IgA nephropathy are related to renal function: a model for estimating risk of progression in mild disease", Clin Nephrol, 58, pp.85~94 (2002)
- Nieuwhof C, "Chronicity index and mesangial IgG deposition are risk factors for hypertension and renal failure in early IgA nephropathy", Am J Kidney Dis, 31, pp.962~970 (1998)
- Fofi C, "IgA nephropathy: multivariate statistical analysis aimed at predicting outcome", J Nephrol, 14, pp.280~285 (2001)
- Fuiano G, "Current indications for renal biopsy: a questionnaire-based survey", Am J Kidney Dis, 35, pp.448~457 (2000)
- Parone DB, "The effect of biopsy on therapy in renal disease", Arch Intern Med, 141, pp.1039~1041 (1981)
- Churg J, "WHO Monograph: Renal Disease. 2nd ed" (1995), Igaku-Shoin
- Donadio JV, "IgA nephropathy", N Engl J Med, 347, pp.738~748 (2002)
- Schena FP, "A retrospective analysis of the natural history of primary IgA nephropathy worldwide", Am J Med, 89, pp.209~215 (1990)
- Tiebosch AT, "Thin basement-membrane nephropathy in adult with persistent hematuria", N Engl J Med, 320, pp.14~18 (1989)
- Pettersson E, "Nephritis among young Finnish men", Clin Nephrol, 22, pp.217~222 (1984)
- D’Amico G, "Tubulointerstitium as predictor of progression of glomerular diseases", Nephron, 83, pp.289~295 (1999)
- Daniel L, "Tubular lesion determine prognosis of IgA nephropathy", Am J KidneyDiss, 35, pp.13~20 (2000)
- Coppo R, "Factors predicting progression of IgA nephropathies", J Nephrol, 18, pp.503~512 (2005)
- Alamartine E, "Comparison of pathological lesions on repeated renal biopsies in 73 patients with primary IgA glomerulonephritis: value of quantitative scoring and approach to final prognosis", Clin Nephrol, 34, pp.45~51 (1990)
- Shu KH, "Long-term outcome of adult patients with minimal urinary abnormalities and normal renal function", Clin Nephrol, 52, pp.5~9 (1999)
- Sparwasser C, "Significance of the evaluation of asymptomatic microscopic haematuria in young men", Br J Urol, 74, pp.723~729 (1994)
- Mariani AJ, "The significance of adult hematuria: 1,000 hematuria evaluations including a risk-benefit and cost-effectiveness analysis", J Urol, 141, pp.350~355 (1989)