Microhematuria Enhances the Risks of Relapse and Renal Progression in Primary Membranous Nephropathy.
Front Med (Lausanne)
; 8: 704830, 2021.
Article
in En
| MEDLINE
| ID: mdl-34957132
ABSTRACT
Objective:
To determine whether there is an association between microhematuria and relapse or kidney disease progression in patients with primary membranous nephropathy (PMN).Methods:
A cohort of 639 patients with biopsy-proven PMN from two centers was followed for a median of 40 months. The exposures were initial hematuria, time-averaged hematuria, and cumulative duration of hematuria. The outcomes were relapse and renal progression, which were defined by a 40% reduction in renal function or end-stage renal disease. Cox proportional hazards regression and competing risk analyses were performed to yield hazard ratios (HRs) and subdistribution hazard ratios (sHRs) with 95% confidence intervals (CIs). Sensitivity and interaction analyses were also performed.Results:
After adjusting for confounders, a higher level of initial hematuria was associated with a 1.43 (95% CI, 1.15-1.78) greater hazard of relapse. Worsening hematuria remarkably increased the risk of short-term relapse (HR, 4.64; 3.29-6.54). Time-averaged hematuria (sHR, 1.35; 1.12-1.63) and cumulative duration of hematuria (sHR, 1.17; 1.02-1.34) were independent predictors of renal progression. Hematuria remission was related to a reduced risk of renal progression over time in patients with positive microhematuria (sHR, 0.63; 0.41-0.96).Conclusions:
A higher level of initial hematuria was a remarkable predictor of relapse in patients with PMN, and the magnitude and persistence of microhematuria were independently associated with kidney disease progression.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Type of study:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Language:
En
Journal:
Front Med (Lausanne)
Year:
2021
Document type:
Article
Affiliation country:
China
Publication country:
CH
/
SUIZA
/
SUÍÇA
/
SWITZERLAND