Hematuria

Peterson, Leah M.; Reed, Henry S.

doi:10.1016/j.pop.2019.02.008

Cited by 20 publications

(15 citation statements)

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“…Hematuria is a clinical symptom of some renal disorders with benign features, and it has been neglected by many clinicians for decades. However, multiple recent studies challenged this concept and demonstrated that the presence of hematuria, especially of glomerular origin, was a hallmark of inflammation and pathological damage in nephridial tissue ( 4 – 6 , 23 ). The accumulation of heavy microhematuria over time may be a predictor of adverse outcomes, e.g., disease activity in systemic lupus erythematosus ( 24 , 25 ), renal relapse in AAV ( 10 , 26 , 27 ), and kidney disease progression in IgAN ( 7 – 9 ).…”

Section: Discussionmentioning

confidence: 99%

“…Microhematuria, accompanied by variable amounts of proteinuria, is one of the most common clinical manifestations of GN, e.g., IgA nephropathy (IgAN), ANCA-associated vasculitis (AAV), and lupus nephritis (1)(2)(3). The significance of hematuria in the natural history of renal disease is not clear (4)(5)(6). Some experts regard persistent hematuria as a hallmark of ongoing disease activity, but other experts posit that stable hematuria is a benign lesion resulting from prior kidney damage (5,6).…”

Section: Introductionmentioning

confidence: 99%

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Microhematuria Enhances the Risks of Relapse and Renal Progression in Primary Membranous Nephropathy

Zha

et al. 2021

Front. Med.

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Objective: To determine whether there is an association between microhematuria and relapse or kidney disease progression in patients with primary membranous nephropathy (PMN).Methods: A cohort of 639 patients with biopsy-proven PMN from two centers was followed for a median of 40 months. The exposures were initial hematuria, time-averaged hematuria, and cumulative duration of hematuria. The outcomes were relapse and renal progression, which were defined by a 40% reduction in renal function or end-stage renal disease. Cox proportional hazards regression and competing risk analyses were performed to yield hazard ratios (HRs) and subdistribution hazard ratios (sHRs) with 95% confidence intervals (CIs). Sensitivity and interaction analyses were also performed.Results: After adjusting for confounders, a higher level of initial hematuria was associated with a 1.43 (95% CI, 1.15–1.78) greater hazard of relapse. Worsening hematuria remarkably increased the risk of short-term relapse (HR, 4.64; 3.29–6.54). Time-averaged hematuria (sHR, 1.35; 1.12–1.63) and cumulative duration of hematuria (sHR, 1.17; 1.02–1.34) were independent predictors of renal progression. Hematuria remission was related to a reduced risk of renal progression over time in patients with positive microhematuria (sHR, 0.63; 0.41–0.96).Conclusions: A higher level of initial hematuria was a remarkable predictor of relapse in patients with PMN, and the magnitude and persistence of microhematuria were independently associated with kidney disease progression.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Microhematuria Enhances the Risks of Relapse and Renal Progression in Primary Membranous Nephropathy

Zha

et al. 2021

Front. Med.

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“…Hematuria is often a common symptom of urinary system disease. A good medical history, physical examination, and focused laboratory investigations for persistent or recurrent gross hematuria may lead to the identification of a long list of causes including infection, glomerulonephritis, stones, trauma, tumor, and so forth ( Joshua et al, 2017 ; Peterson & Reed, 2019 ). But many rare causes still exist, including AVM, vascular fistula, renal nutcracker syndrome, vesical varices, pyelovenous fistula, and so forth ( Bin_ Dahman & Aljabry, 2019 ; Valdez Vargas et al, 2018 ).…”

Section: Discussionmentioning

confidence: 99%

“…Thus, the clinician should turn his or her attention to the patient with gross hematuria. Many diseases may cause hematuria, such as malignancy, benign tumor, infection, menstruation, urolithiasis, trauma, urinary anatomic disease, renal disease, chemical, and hematologic/vascular disease ( Joshua et al, 2017 ; Peterson & Reed, 2019 ). The commonest cause is infection of the lower urinary tract, particularly infection of the bladder ( Bin_ Dahman & Aljabry, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

Superselective Arterial Embolization of Arteriovenous Malformation of Internal Pudendal Artery, a Rare Cause of Hematuria: A Case Report

Qiu

Wei

et al. 2020

Am J Mens Health

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Arteriovenous malformation (AVM) is a common form of vascular malformation, an abnormal direct communication between an artery and a vein without passing through the capillaries. AVM may just present as hematuria without plain or other symptoms. The article presents a case of a 52-year-old male with gross hematuria diagnosed as AVM of internal pudendal artery, which was successfully managed with superselective arterial embolization using temporary embolization materials.

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“…Proteinuria is defined as urine ACR values ≥30 mg/g or >1+ proteinuria on dipstick [9]. Nephrotic syndrome is defined as ACR values ≥2000 mg/g (≥200 mg/mmol) or >3+ proteinuria on dipstick with serum albumin <25 g/L (25 g/L).Hematuria is defined as the presence of red blood cells in the urine including gross hematuria and microscopic hematuria(as defined as greater than or equal to 3 RBCs per HPF) [10]. AKI is defined as increase in SCr by ≥0.3 mg/dl (≥26.5 lmol/l) within 48 hours; or increase in SCr to ≥1.5 times baseline, which is known or presumed to have occurred within the prior 7 days; or urine volume <0.5 ml/kg/h for 6 hours [11].…”

Section: Methodsmentioning

confidence: 99%

Renal involvement as the first symptom of multiple myeloma

Zhang

Zhong

et al. 2019

Preprint

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Background . Renal involvement is a common complication of multiple myeloma (MM). However, most studies have focused on renal failure in MM, and little information is available about the other renal manifestations in MM and their association with immunophenotypes and renal pathology. Methods . We retrospectively analyzed the clinical, laboratory and pathology data of 283 MM patients treated in Sichuan Provincial People’s Hospital, West China, between January 1990 and May 2017. The patients were divided into a renal involvement group (n = 200) and a non-renal involvement group (n = 83). Results. In the renal involvement group, 90 (45.0%) patients were diagnosed with MM in the Nephrology department, and isolated proteinuria, renal failure and nephrotic syndrome were detected in 90(45.0%), 94 (47.0%) and 58 (29.0%) patients, respectively. 135 patients with renal involvement underwent immunofixation electrophoresis, and IgG, IgA, IgD, IgE, pure light chain and nonsecretory MM were detected in 52 (38.5%), 32 (23.7%), 1 (0.7%), 1 (0.7%), 45(33.3%) and 4 (3.0%) patients, respectively. 47 patients without renal involvement also underwent immunofixation electrophoresis, and IgG and IgA MM were found in 24 (51.0%) and 18 (38.3%) patients, respectively. Severe anemia and hypertension, hypercalcemia and pure light chain were more frequent in patients with renal involvement (P < 0.05).9 patients with renal involvement were performed renal biopsy, and cast nephropathy, renal amyloidosis were proved in 5 and 4 patients, respectively. Conclusions. Renal involvement was common at MM diagnosis and had diverse clinical manifestations. The most common clinical manifestations include renal failure, isolated albuminuria and nephrotic syndrome. Nephrologists should rule out MM in patients presenting with renal involvement.

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Hematuria

Cited by 20 publications

References 10 publications

Microhematuria Enhances the Risks of Relapse and Renal Progression in Primary Membranous Nephropathy

Microhematuria Enhances the Risks of Relapse and Renal Progression in Primary Membranous Nephropathy

Superselective Arterial Embolization of Arteriovenous Malformation of Internal Pudendal Artery, a Rare Cause of Hematuria: A Case Report

Renal involvement as the first symptom of multiple myeloma

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