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- Title
Microscopic hematuria is a risk factor of incident chronic kidney disease in the Korean general population: a community-based prospective cohort study.
- Authors
Kim, H; Lee, M; Cha, M -U; Nam, K H; An, S Y; Park, S; Jhee, J H; Yun, H -R; Kee, Y K; Park, J T; Yoo, T -H; Kang, S -W; Han, S H
- Abstract
Background Although asymptomatic microscopic hematuria (MH) is a common finding in clinical practice, its long-term outcome remains unknown. Aim This study evaluated the clinical implication of MH in the general population using a large-scale long-term longitudinal cohort database. Methods This study included 8719 participants from the Korean Genome and Epidemiology Study between 2001 and 2014. MH was defined as ≥5 red blood cells per high-power field in random urinalysis without evidence of pyuria. The primary study outcome measure was incident chronic kidney disease (CKD), defined as estimated glomerular filtration rate <60 ml min−1⋅1.73⋅m−2. Results During a median follow-up of 11.7 years, CKD occurred in 677 (7.8%) subjects. In Cox regression after adjustment for multiple confounders, subjects with MH had a significantly higher risk of incident CKD than those without [hazard ratio (HR) 1.45, 95% confidence interval (CI) 1.12–1.87; P = 0.005]. Isolated MH without proteinuria was also a risk factor of incident CKD (HR 1.37, 95% CI 1.04–1.79; P = 0.023) and the risk was further increased in MH with concomitant proteinuria (HR 5.41, 95% CI 2.54–11.49; P < 0.001). In propensity score matching analysis after excluding subjects with proteinuria, multi-variable stratified Cox regression analysis revealed that subjects with isolated MH had a significantly higher risk of incident CKD than those without (HR 1.83, 95% CI 1.14–2.94; P = 0.012). Conclusion The presence of MH is associated with an increased risk of incident CKD in the general population. Therefore, attentive follow-up is warranted in persons with MH for early detection of CKD.
- Subjects
CHRONIC kidney failure; LONGITUDINAL method; RANDOM fields; ERYTHROCYTES; PROPENSITY score matching
- Publication
QJM: An International Journal of Medicine, 2018, Vol 111, Issue 6, p389
- ISSN
1460-2725
- Publication type
Article
- DOI
10.1093/qjmed/hcy054