TY - JOUR
T1 - Microscopic hematuria is a risk factor of incident chronic kidney disease in the Korean general population
T2 - A community-based prospective cohort study
AU - Kim, H.
AU - Lee, M.
AU - Cha, M. U.
AU - Nam, K. H.
AU - An, S. Y.
AU - Park, S.
AU - Jhee, J. H.
AU - Yun, H. R.
AU - Kee, Y. K.
AU - Park, J. T.
AU - Yoo, T. H.
AU - Kang, S. W.
AU - Han, S. H.
N1 - Publisher Copyright:
© The Author(s) 2018. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved.
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2018/6/1
Y1 - 2018/6/1
N2 - 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.
AB - 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.
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U2 - 10.1093/qjmed/hcy054
DO - 10.1093/qjmed/hcy054
M3 - Article
C2 - 29554373
AN - SCOPUS:85048569841
VL - 111
SP - 389
EP - 397
JO - QJM - Monthly Journal of the Association of Physicians
JF - QJM - Monthly Journal of the Association of Physicians
SN - 1460-2725
IS - 6
ER -