TY - JOUR
T1 - Hematuria and risk for end-stage kidney disease
AU - Vivante, Asaf
AU - Calderon-Margalit, Ronit
AU - Skorecki, Karl
PY - 2013/5
Y1 - 2013/5
N2 - Purpose of review: Hematuria is a common clinical finding requiring medical attention and poses several clinical challenges. The main challenge is to predict the future risk for chronic kidney disease and therefore to design a longterm follow-up evaluation and treatment plan. This review focuses on the risk for subsequent end-stage kidney disease among young persons with persistent isolated microscopic hematuria. Recent findings: It has been recently recognized that young persons with persistent isolated microscopic hematuria have an increased risk for end-stage kidney disease, mainly secondary to primary glomerular diseases. These predominantly include IgA nephropathy, thin basement membrane disease, and Alport syndrome. Among these causes, the association with progression to chronic kidney disease is best established for IgA nephropathy and Alport syndrome. Thin basement membrane disease had been considered 'benign' by most authors, although recent findings suggest otherwise. In addition, novel diagnostic markers and therapeutic interventions for these conditions have recently been studied. Summary: Persistent isolated microscopic hematuria confers a risk for future chronic kidney disease, which is dependent on disease context, underlying genetics, environment interactions, and treatment. 'Benign (familial) hematuria' is a misnomer, which we recommend abandoning as it prompts loss to follow-up. Instead, we favor annual/biennial follow-up assessment that should include measurement of blood pressure, urinalysis, and kidney function tests.
AB - Purpose of review: Hematuria is a common clinical finding requiring medical attention and poses several clinical challenges. The main challenge is to predict the future risk for chronic kidney disease and therefore to design a longterm follow-up evaluation and treatment plan. This review focuses on the risk for subsequent end-stage kidney disease among young persons with persistent isolated microscopic hematuria. Recent findings: It has been recently recognized that young persons with persistent isolated microscopic hematuria have an increased risk for end-stage kidney disease, mainly secondary to primary glomerular diseases. These predominantly include IgA nephropathy, thin basement membrane disease, and Alport syndrome. Among these causes, the association with progression to chronic kidney disease is best established for IgA nephropathy and Alport syndrome. Thin basement membrane disease had been considered 'benign' by most authors, although recent findings suggest otherwise. In addition, novel diagnostic markers and therapeutic interventions for these conditions have recently been studied. Summary: Persistent isolated microscopic hematuria confers a risk for future chronic kidney disease, which is dependent on disease context, underlying genetics, environment interactions, and treatment. 'Benign (familial) hematuria' is a misnomer, which we recommend abandoning as it prompts loss to follow-up. Instead, we favor annual/biennial follow-up assessment that should include measurement of blood pressure, urinalysis, and kidney function tests.
KW - Alport syndrome
KW - CKD
KW - Hematuria
KW - IgA nephropathy
KW - TBMD
UR - http://www.scopus.com/inward/record.url?scp=84878854459&partnerID=8YFLogxK
U2 - 10.1097/MNH.0b013e32835f7241
DO - 10.1097/MNH.0b013e32835f7241
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C2 - 23449218
AN - SCOPUS:84878854459
SN - 1062-4821
VL - 22
SP - 325
EP - 330
JO - Current Opinion in Nephrology and Hypertension
JF - Current Opinion in Nephrology and Hypertension
IS - 3
ER -