Asymptomatic Microscopic Hematuria Ups Youth ESRD Risk

Higher end-stage renal disease risk in youth with asymptomatic isolated microscopic hematuria

TUESDAY, Aug. 16 (HealthDay News) -- Young adults with persistent asymptomatic isolated microscopic hematuria have a significantly increased risk of treated end-stage renal disease (ESRD), although the incidence and absolute risk remain quite low for prolonged periods, according to a study published in the Aug. 17 issue of the Journal of the American Medical Association.

Asaf Vivante, M.D., from the Sheba Medical Center in Tel Hashomer, Israel, and colleagues investigated the risk of ESRD in 3,690 young adults with persistent asymptomatic isolated microscopic hematuria. Medical data from 1,203,626 individuals, aged 16 to 25 years (60 percent male), examined for fitness for military service between 1975 and 1997 were linked to the Israeli treated ESRD registry. Incident treated ESRD cases were identified from 1980 to 2010 (follow-up, 21.88 years), and the hazard ratio (HR) of treated ESRD estimated. Date of initiation of dialysis or date of renal transplantation, whichever came first, was the main outcome measure indicating treated ESRD onset.

The investigators identified treated ESRD in 26 individuals with and 539 without persistent asymptomatic isolated microscopic hematuria, yielding incidence rates of 34.0 and 2.05 per 100,000 person-years, respectively (crude HR, 19.5). Multivariate adjustments did not alter the risk associated with persistent asymptomatic isolated microscopic hematuria (HR, 18.5). Patients with persistent asymptomatic isolated microscopic hematuria had a substantially increased risk for treated ESRD attributed to primary glomerular disease than those without (HR, 32.4; incidence rates, 19.6 versus 0.55 per 100 000 person-years). A total of 4.3 percent of treated ESRD was attributed to microscopic hematuria.

"Presence of persistent asymptomatic isolated microscopic hematuria in persons aged 16 through 25 years was associated with significantly increased risk of treated ESRD for a period of 22 years," the authors write.

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