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Persistent asymptomatic isolated hematuria in children: clinical and histopathological features and prognosis
Chun-Yue Feng, Yong-Hui Xia, Wen-Jin Wang, Jin Xia, Hai-Dong Fu, Xia Wang, Hui-Jun Shen, Gu-Ling Qian, Ai-Min Liu, Jian-Hua Mao
Hangzhou, China
Author Affiliations: Department of Nephrology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China (Feng CY, Xia YH, Wang WJ, Xia J, Fu HD, Wang X, Shen HJ, Qian GL, Liu AM, Mao JH)
Corresponding Author: Yong-Hui Xia, Department of Nephrology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China (Tel: 86-571-87061007; Fax: 86-571-87033296; Email: xyhhz916@sohu.com)
doi: 10.1007/s12519-013-0415-3
Background: This study involving 351 children who had undergone kidney biopsy secondary to persistent asymptomatic isolated hematuria was undertaken to assess histological diagnosis of the disease and its natural history and prognosis.
Methods: The patients were divided into two groups: 215 patients with asymptomatic isolated microhematuria (AIMH; proteinuria <0.1 g⁄day) and 136 patients with persistent asymptomatic microhematuria, recurrent macrohematuria and/or proteinuria (AMHP; proteinuria 0.1-0.25 g/day). After kidney biopsy, the patients were monitored for 2-10 years.
Results: Normal biopsies or minor abnormalities were more frequent in AIMH patients than those in AMHP patients, who exhibited IgA nephropathy more frequently. During the 2- to 10-year follow-up period, adverse renal events (i.e., development of proteinuria, hypertension, or impaired renal function) were observed in 13/215 (6.0%) patients with AIMH and 31/136 (22.8%) patients with AMHP (¦Ö2=15.521, P<0.001).
Conclusions: Normal biopsies or minor abnormalities were more frequently observed in AIMH patients, whereas IgA nephropathy and adverse renal events were more frequent in AMHP. Microscopic hematuria, especially when accompanied by macroscopic hematuria and proteinuria, may represent an important risk factor for the development of chronic kidney disease.
Key words: adverse renal events; asymptomatic isolated hematuria; proteinuria
World J Pediatr 2013;9(2):163-168
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