Abstract
Microscopic haematuria is proposed as a prognostic factor for renal outcomes in patients with glomerulonephritis. However, the role of haematuria in patients with advanced chronic kidney disease (CKD) or heavy proteinuria has not been investigated. We divided 1799 patients with stage 3–5 nondiabetic CKD into 3 groups according to the results from 3 urinalyses: no haematuria (0–2 red blood cells [RBCs]/hpf ≥2 times), mild haematuria (2–5 RBCs/hpf ≥2 times) and moderate haematuria (≥5–10 RBCs/hpf ≥2 times). The estimated glomerular filtration rate was 25.4 mL/min/1.73 m2, with a urine protein-to-creatinine ratio (UPCR) of 881 mg/g. The hazard ratios (HRs) of mild and moderate haematuria for end-stage renal disease (ESRD) were 1.28 (95% confidence interval [CI]: 1.05–1.56, P = 0.024) and 1.34 (95% CI: 1.03–1.74, P = 0.030), respectively. The HR of moderate haematuria for mortality was 1.56 (95% CI: 1.11–2.20, P = 0.011). According to subgroup analysis, the HR of moderate haematuria for ESRD in patients with a UPCR of <500 mg/g was more prominent than that in patients with a UPCR of ≥500 mg/g. Microscopic haematuria in patients with stage 3–5 nondiabetic CKD is associated with increased risks of ESRD and mortality.
Highlights
Haematuria might be a risk factor for poor renal outcomes in patients with early-stage GN
The patients were divided into 3 groups according to the severity of haematuria in 2 out of 3 consecutive urinalyses: Group 1, no haematuria (0-2 red blood cells (RBCs)/hpf or ≥ 2–5 RBCs/hpf only once in 3 analyses); Group 2, mild haematuria (2–5 RBCs/ hpf ≥ 2 times); and Group 3, moderate haematuria (≥ 5–10 RBCs/hpf ≥ 2 times)
The present study investigated whether haematuria was associated with clinical outcomes in a stage 3–5 nondiabetic chronic kidney disease (CKD) cohort, revealing that haematuria was associated with proteinuria, hypoalbuminemia, and a high CRP
Summary
Haematuria might be a risk factor for poor renal outcomes in patients with early-stage GN. In the general population, isolated haematuria without proteinuria has been associated with a high risk of ESRD after long-term follow-up; the incidence is as low as 0.3%3,4. 15%–20% of patients with IgAN or other proliferative GN with isolated haematuria develop proteinuria[5,6]. Studies have considered haematuria as a risk factor for the progression of renal function and ESRD in patients www.nature.com/scientificreports/. The prognostic value of haematuria for ESRD in nondiabetic patients with advanced-stage CKD or heavy proteinuria remains incompletely understood. In the present study, we hypothesised that haematuria is associated with ESRD and other clinical outcomes in patients with stage 3–5 nondiabetic CKD, assessing this hypothesis by examining an observational cohort of patients with CKD
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