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Published on: November 1, 2018
Natural history and renal pathology in patients with isolated microscopic hematuria
Byung Soo Kim1, Yong Kyun Kim, Young Shin Shin
1Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
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.
Insights
Patients with isolated microscopic hematuria (IMH) generally have a good prognosis. However, those who develop proteinuria or hypertension need close monitoring for potential chronic kidney disease progression.
Area of Science:
- Nephrology
- Internal Medicine
- Pathology
Background:
- The natural history of isolated microscopic hematuria (IMH) remains incompletely understood.
- Previous studies have not definitively established prognosis or risk factors for IMH patients.
Purpose of the Study:
- To observe the natural history of patients diagnosed with IMH.
- To identify factors associated with pathologic diagnoses and patient prognosis.
Main Methods:
- Retrospective evaluation of 156 patients with IMH who underwent renal biopsy.
- Analysis of biopsy results including IgA nephropathy, mesangial proliferative glomerulonephritis, glomerular minor lesions, thin basement membrane nephropathy, and normal biopsies.
- Follow-up of 100 subjects for approximately 31 months.
Main Results:
- Common diagnoses included IgA nephropathy (33.3%) and mesangial proliferative glomerulonephritis (23.7%).
- During follow-up, two patients with IgA nephropathy developed chronic kidney disease, presenting with proteinuria and/or hypertension.
- Overall incidences of proteinuria and hypertension were 6% and 5%, respectively.
Conclusions:
- Isolated microscopic hematuria generally carries a favorable prognosis.
- Patients with IMH who develop proteinuria and/or hypertension require vigilant observation and management.
- Early identification of risk factors can guide clinical management for better patient outcomes.
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