Long-Term Follow-up of Asymptomatic Hematuria and/or Proteinuria in Adults

Park, Joo Hyun; Kim, Hyung Keun; Oh, Eun Sook; Park, Jung Hee; Yang, Chul Woo; Kim, Yong Soo; Chang, Yoon Sik; Bang, Byung Kee

Abstract

To determine the clinical outcome of patients with asymptomatic hematuria and/or proteinuria, the biochemical parameters and renal biopsies were reviewed. The patients with asymptomatic urinary abnormalities(n=193) were followed up in Kangnam St. Mary's hospital between 1981 and 1996 and their mean age was 38.8+/-14.0 years old, sex ratio of M:F 54:139, mean follow-up period 6.2+/-4.4 years. They were divided into three groups according to the first dipstick urinalysis findings:82 patients with isolated hematuria(H), 28 patients with isolated proteinuria(P), and 83 patients with concomitant hematuria and proteinuria(H+P). During the follow-up period, in the 82 patiets with H, 68.3% had persistent hematuria without proteinuria, hematuria disappeared in 23.2%, and 8.5% manifested proteinuria, none of the patients showed renal insufficiency. Of the 28 patients with P, 42.9% had persistent proteinuria, proteinuria disappeared in 39.3%, 10.7% manifested hematuria, and 7.1% showed renal insufficiency. Of the 83 patients with H+P, 51.8% had persistent hematuria and proteinuria, hematuria and proteinuria disappeared in 13.3%, 16.9% had persistent hematuria without proteinuria, 9.6% had persistent proteinuria without hematuria, and 8.4% showed renal insufficiency. Renal biopsy was performed in 79 patients. 75.9% of these patients had Ig A nephropathy, 11.4% had mesangial proliferative glomerulonephritis or mesangiopathy, and 8.9% had membranous proliferative glomerulonephritis. In conclusion, the most common cause of asymptomatic urinary abnormalities was Ig A nephropathy(75.9%) and all patients with isolated hematuria kept normal renal function, while some patients with proteinuria(7.1%) or concomitant hematuria and proteinuria(8.4%) progressed to chronic renal failure. Therefore, to monitor progressing to chronic renal failure, the patients with proteinuria(whether or not they showed concomitant hematuria) should be closely followed up.