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Haematuria as a risk factor for chronic kidney disease progression in glomerular diseases: A review

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Abstract

Haematuria has long been considered to be a benign condition associated with glomerular diseases. However, new evidences suggest that haematuria has a pathogenic role in promoting kidney disease progression. An increased risk for end-stage renal disease has been reported in adolescents and young adults with persistent microscopic haematuria. A persistent impairment of renal function has been also reported following macroscopic haematuria-associated acute kidney injury in immunoglobulin A nephropathy. Haematuria-induced renal damage has been related to oxidant, cytotoxic and inflammatory effects induced by haemoglobin or haem released from red blood cells. The pathophysiological origin of haematuria may be due to a more fragile and easily ruptured glomerular filtration barrier, as reported in several glomerular diseases. In this review we describe a number of the key issues associated with the epidemiology and pathogenesis of haematuria-associated diseases, provide an update of recent knowledge on the role of haematuria on renal function outcome and discuss specific therapeutic approaches in this setting.

Key summary points

  1. 1.

    Glomerular haematuria is a common observation in a number of renal diseases that may lead to persistent renal injury.

  2. 2.

    Haematuria in children differs from that in adults in specific aspects, particularly in the frequency of glomerular diseases and renal disease outcome.

  3. 3.

    Regular follow-up of renal function in children with isolated microhaematuria may be recommended.

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Acknowledgements

This study has been supported by grants from FIS (Programa Miguel Servet: CP10/00479, PI13/00802 and PI14/00883) and the Spanish Society of Nephrology to JAM, FIS 10/02668 and 13/02502, REDinREN (RD012/0021) and by Complement Research Group-CM (S2010/BMD-2316) to MP, Fundacion Conchita Rabago to ARN, and the Institute of Research Queen Sophia, FRIAT and ISCIII fund PI14/00386 to JE.

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Authors and Affiliations

  1. Renal, Vascular and Diabetes Research Laboratory, IIS-Fundación Jiménez Díaz, Autonoma University, Av. Reyes Católicos 2, 28040, Madrid, Spain

    Juan Antonio Moreno, Alfonso Rubio-Navarro, Juan Manuel Amaro-Villalobos & Jesús Egido

  2. Department of Nephrology, Gregorio Marañon Hospital, 28007, Madrid, Spain

    Claudia Yuste

  3. Department of Nephrology, 12 de Octubre Hospital, 28041, Madrid, Spain

    Eduardo Gutiérrez, Ángel M. Sevillano & Manuel Praga

  4. Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain

    Jesús Egido

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  1. Juan Antonio Moreno
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  2. Claudia Yuste
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Correspondence to Juan Antonio Moreno.

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Moreno, J.A., Yuste, C., Gutiérrez, E. et al. Haematuria as a risk factor for chronic kidney disease progression in glomerular diseases: A review. Pediatr Nephrol 31, 523–533 (2016). https://doi.org/10.1007/s00467-015-3119-1

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  • DOI: https://doi.org/10.1007/s00467-015-3119-1

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