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Haematuria increases progression of advanced proteinuric kidney disease.

Yuste C, Rubio-Navarro A, Barraca D, Aragoncillo I, Vega A, Abad S, Santos A, Macias N, Mahillo I, Gutiérrez E, Praga M, Egido J, López-Gómez JM, Moreno JA - PLoS ONE (2015)

Bottom Line: To determine the influence of haematuria on the rate of chronic kidney disease (CKD) progression in 71 proteinuric patients with advanced CKD (baseline eGFR <30 mL/min) during 12 months of follow-up.The deleterious effect of haematuria on rate of decline in eGFR was observed in patients <65 years (-6.8±9.9 (HP) vs. 0.1±11.7 (P) mL/min/1.73 m2/year, p<0.05), but not in patients >65 years (-1.2±6.8 (HP) vs. 1.5±7.7 (P) mL/min/1.73 m2/year).Multivariate analysis reported that presence of haematuria was significantly and independently associated with eGFR deterioration after adjusting for traditional risk factors, including age, serum phosphate, mean proteinuria and mean serum PTH (β=-4.316, p=0.025).

View Article: PubMed Central - PubMed

Affiliation: Renal Unit. Gregorio Marañón Hospital, Madrid, Spain.

ABSTRACT

Background: Haematuria has been traditionally considered as a benign hallmark of some glomerular diseases; however new studies show that haematuria may decrease renal function.

Objective: To determine the influence of haematuria on the rate of chronic kidney disease (CKD) progression in 71 proteinuric patients with advanced CKD (baseline eGFR <30 mL/min) during 12 months of follow-up.

Results: The mean rate of decline in eGFR was higher in patients with both haematuria and proteinuria (haemoproteinuria, HP, n=31) than in patients with proteinuria alone (P patients, n=40) (-3.8±8.9 vs 0.9±9.5 mL/min/1.73 m2/year, p<0.05, respectively). The deleterious effect of haematuria on rate of decline in eGFR was observed in patients <65 years (-6.8±9.9 (HP) vs. 0.1±11.7 (P) mL/min/1.73 m2/year, p<0.05), but not in patients >65 years (-1.2±6.8 (HP) vs. 1.5±7.7 (P) mL/min/1.73 m2/year). Furthermore, the harmful effect of haematuria on eGFR slope was found patients with proteinuria >0.5 g/24 h (-5.8±6.4 (HP) vs. -1.37± 7.9 (P) mL/min/1.73 m2/year, p<0.05), whereas no significant differences were found in patients with proteinuria < 0.5 g/24 h (-0.62±7.4 (HP) vs. 3.4±11.1 (P) mL/min/1.73 m2/year). Multivariate analysis reported that presence of haematuria was significantly and independently associated with eGFR deterioration after adjusting for traditional risk factors, including age, serum phosphate, mean proteinuria and mean serum PTH (β=-4.316, p=0.025).

Conclusions: The presence of haematuria is closely associated with a faster decrease in renal function in advanced proteinuric CKD patients, especially in younger CKD patients with high proteinuria levels; therefore this high risk subgroup of patients would benefit of intensive medical surveillance and treatment.

No MeSH data available.


Related in: MedlinePlus

Differences in the mean annual eGFR slope in patients according to proteinuria levels and presence of haematuria.Values are expressed as mean±SD.
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pone.0128575.g003: Differences in the mean annual eGFR slope in patients according to proteinuria levels and presence of haematuria.Values are expressed as mean±SD.

Mentions: To determine whether the effect of haematuria on eGFR slope was associated to proteinuria, our patients were equally distributed into two groups according to the median proteinuria value obtained along the study. Thus, patients were divided into two groups: patients with proteinuria < 0.5 g/24 h or patients with proteinuria > 0.5 g/24 h. The harmful effect of haematuria on eGFR slope was found in patients with proteinuria >0.5 g/24 h (-5.8±6.4 (HP) vs. -1.37± 7.9 (P) mL/min/1.73m2/year, p<0.05), whereas no significant difference was found in those patients with proteinuria <0.5 g/24 h (-0.62±7.4 (HP) vs. 3.4±11.1 (P) mL/min/1.73m2/year) (Fig 3). No differences were found between haematuric and non haematuric patients in mean proteinuria, serum mean phosphate or serum mean PTH, gender or hypertension according with proteinuria degree (Table 3).


Haematuria increases progression of advanced proteinuric kidney disease.

Yuste C, Rubio-Navarro A, Barraca D, Aragoncillo I, Vega A, Abad S, Santos A, Macias N, Mahillo I, Gutiérrez E, Praga M, Egido J, López-Gómez JM, Moreno JA - PLoS ONE (2015)

Differences in the mean annual eGFR slope in patients according to proteinuria levels and presence of haematuria.Values are expressed as mean±SD.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4446357&req=5

pone.0128575.g003: Differences in the mean annual eGFR slope in patients according to proteinuria levels and presence of haematuria.Values are expressed as mean±SD.
Mentions: To determine whether the effect of haematuria on eGFR slope was associated to proteinuria, our patients were equally distributed into two groups according to the median proteinuria value obtained along the study. Thus, patients were divided into two groups: patients with proteinuria < 0.5 g/24 h or patients with proteinuria > 0.5 g/24 h. The harmful effect of haematuria on eGFR slope was found in patients with proteinuria >0.5 g/24 h (-5.8±6.4 (HP) vs. -1.37± 7.9 (P) mL/min/1.73m2/year, p<0.05), whereas no significant difference was found in those patients with proteinuria <0.5 g/24 h (-0.62±7.4 (HP) vs. 3.4±11.1 (P) mL/min/1.73m2/year) (Fig 3). No differences were found between haematuric and non haematuric patients in mean proteinuria, serum mean phosphate or serum mean PTH, gender or hypertension according with proteinuria degree (Table 3).

Bottom Line: To determine the influence of haematuria on the rate of chronic kidney disease (CKD) progression in 71 proteinuric patients with advanced CKD (baseline eGFR <30 mL/min) during 12 months of follow-up.The deleterious effect of haematuria on rate of decline in eGFR was observed in patients <65 years (-6.8±9.9 (HP) vs. 0.1±11.7 (P) mL/min/1.73 m2/year, p<0.05), but not in patients >65 years (-1.2±6.8 (HP) vs. 1.5±7.7 (P) mL/min/1.73 m2/year).Multivariate analysis reported that presence of haematuria was significantly and independently associated with eGFR deterioration after adjusting for traditional risk factors, including age, serum phosphate, mean proteinuria and mean serum PTH (β=-4.316, p=0.025).

View Article: PubMed Central - PubMed

Affiliation: Renal Unit. Gregorio Marañón Hospital, Madrid, Spain.

ABSTRACT

Background: Haematuria has been traditionally considered as a benign hallmark of some glomerular diseases; however new studies show that haematuria may decrease renal function.

Objective: To determine the influence of haematuria on the rate of chronic kidney disease (CKD) progression in 71 proteinuric patients with advanced CKD (baseline eGFR <30 mL/min) during 12 months of follow-up.

Results: The mean rate of decline in eGFR was higher in patients with both haematuria and proteinuria (haemoproteinuria, HP, n=31) than in patients with proteinuria alone (P patients, n=40) (-3.8±8.9 vs 0.9±9.5 mL/min/1.73 m2/year, p<0.05, respectively). The deleterious effect of haematuria on rate of decline in eGFR was observed in patients <65 years (-6.8±9.9 (HP) vs. 0.1±11.7 (P) mL/min/1.73 m2/year, p<0.05), but not in patients >65 years (-1.2±6.8 (HP) vs. 1.5±7.7 (P) mL/min/1.73 m2/year). Furthermore, the harmful effect of haematuria on eGFR slope was found patients with proteinuria >0.5 g/24 h (-5.8±6.4 (HP) vs. -1.37± 7.9 (P) mL/min/1.73 m2/year, p<0.05), whereas no significant differences were found in patients with proteinuria < 0.5 g/24 h (-0.62±7.4 (HP) vs. 3.4±11.1 (P) mL/min/1.73 m2/year). Multivariate analysis reported that presence of haematuria was significantly and independently associated with eGFR deterioration after adjusting for traditional risk factors, including age, serum phosphate, mean proteinuria and mean serum PTH (β=-4.316, p=0.025).

Conclusions: The presence of haematuria is closely associated with a faster decrease in renal function in advanced proteinuric CKD patients, especially in younger CKD patients with high proteinuria levels; therefore this high risk subgroup of patients would benefit of intensive medical surveillance and treatment.

No MeSH data available.


Related in: MedlinePlus