Abstract
Glomerular hematuria is a cardinal symptom of renal disease. Glomerular hematuria may be classified as microhematuria or macrohematuria according to the number of red blood cells in urine. Recent evidence suggests a pathological role of persistent glomerular microhematuria in the progression of renal disease. Moreover, gross hematuria, or macrohematuria, promotes acute kidney injury (AKI), with subsequent impairment of renal function in a high proportion of patients. In this pathological context, hemoglobin, heme, or iron released from red blood cells in the urinary space may cause direct tubular cell injury, oxidative stress, pro-inflammatory cytokine production, and further monocyte/macrophage recruitment. The aim of this manuscript is to review the role of glomerular hematuria in kidney injury, the role of inflammation as cause and consequence of glomerular hematuria, and to discuss novel therapies to combat hematuria.
Highlights
Hematuria is described as the presence of red blood cells (RBCs) in the urine
Immunosuppressor therapy, and most corticosteroids, seems a logical option to treat macrohematuria episodes because inflammation is implicated in this phenomenon and because patients with IgA nephropathy (IgAN), antineutrophil cytoplasmic antibody (ANCA)-vasculitis, or lupus nephritis that respond to this therapy usually experience hematuria disappearance
Since macrohematuria bouts are usually preceded by upper respiratory infection, tonsillectomy may be considered as another approach in IgAN patients with recurrent tonsillitis, though the results are contradictory [86]
Summary
Hematuria is described as the presence of red blood cells (RBCs) in the urine. Dysmorphic (abnormally shaped) RBCs in the urine are the consequence of RBC egression through the glomerular filtration barrier, and indicate hematuria of glomerular origin. Glomerular hematuria is a frequent manifestation of many renal diseases, and may be classified as microscopic or macroscopic according to its intensity. Recent evidence suggests a negative repercussion of glomerular hematuria on kidney function. Gross hematuria promotes acute kidney injury (AKI), with a subsequent impairment of renal function by different pathological mechanisms, including an exacerbated inflammatory response. We will fully address the role of glomerular hematuria on kidney injury, emphasizing the causes as well as the pathophysiological consequences
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
