Microscopic hematuria is a risk factor of incident chronic kidney disease in the Korean general population: A community-based prospective cohort study

H. Kim, M. Lee, M. U. Cha, K. H. Nam, S. Y. An, S. Park, J. H. Jhee, H. R. Yun, Y. K. Kee, J. T. Park, T. H. Yoo, S. W. Kang, S. H. Han

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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.

Original languageEnglish
Pages (from-to)389-397
Number of pages9
JournalQJM
Volume111
Issue number6
DOIs
Publication statusPublished - 2018 Jun 1

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All Science Journal Classification (ASJC) codes

  • Medicine(all)

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