Korean Journal of Nephrology 1999;18(4):543-549.

무증상의 혈뇨와 무증상의 단백뇨를 보인 성인환자의 장기추적 조사 (Long-Term Follow-up of Asymptomatic Hematuria and/or Proteinuria in Adults)

박주현, 김형근, 오은숙, 박정희, 양철우, 김용수, 장윤식, 방병기 (Joo Hyun Park, Hyung Keun Kim, Eun Sook Oh, Jung Hee Park, Chul Woo Yang, Yong Soo Kim, Yoon Sik Chang and Byung Kee Bang)

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.