Donald A. Molony, MD
What is the risk for end-stage renal disease (ESRD) in adolescents and young adults with persistent, asymptomatic, isolated microscopic hematuria?
Inception cohort followed for a mean of 22 years.
3690 Jewish military recruits, 16 to 25 years of age (mean age 18 y, 75% men), who were diagnosed with persistent, asymptomatic, isolated microscopic hematuria (≥ 5 red blood cells per high-power field for urine specimens on 3 separate occasions, normal serum creatinine values, no abnormalities on renal imaging studies, otherwise asymptomatic with no known or apparent disease causing hematuria, and evaluation and confirmation by a nephrologist) during mandatory medical board examination. 1 199 936 recruits without hematuria comprised the control group. Exclusion criteria were diabetes mellitus, systemic lupus erythematosus, vasculitis, hypertension, kidney disease or anomalies, or proteinuria determined by dipstick testing.
Age, sex, paternal country of origin, body mass index, blood pressure, and decade of baseline examination.
Start of treatment for ESRD (date of dialysis initiation or renal transplantation, whichever came first) determined by linkage with a national treated ESRD database.
565 participants were treated for ESRD (incidence 2.15 per 100 000 person-y). At 22-year follow-up, participants with persistent, asymptomatic, isolated microscopic hematuria were at increased risk for treated ESRD and for primary glomerular-associated ESRD compared with controls (Table).
Adolescents and young adults with persistent, asymptomatic, isolated microscopic hematuria were at increased risk for end-stage renal disease over 22 years of follow-up.
*Abbreviations defined in Glossary.
†Adjusted for age, sex, paternal country of origin, period of enrollment, body mass index, and blood pressure at baseline.
Molony DA. Young adults with persistent, asymptomatic, isolated microscopic hematuria were at increased risk for ESRD. Ann Intern Med. ;155:JC6–12. doi: 10.7326/0003-4819-155-12-201112200-02012
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Published: Ann Intern Med. 2011;155(12):JC6-12.
Chronic Kidney Disease, Nephrology, Urological Disorders.
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