title: Long-term outcome of IgA nephropathy patients with recurrent macroscopic hematuria.
abstract: OBJECTIVE
  The long-term renal outcomes of patients with IgA nephropathy (IgAN) who present with recurrent macroscopic hematuria (RMH) have not been described in previous studies.
  
  
  METHODS
  Patients with biopsy-proven primary IgAN in Jinling Hospital were divided into three groups according to different patterns of macroscopic hematuria (MH): RMH, isolated MH (IMH), and those without a history of MH (NMH).
  
  
  RESULTS
  A total of 1,155 patients were enrolled in the study (158 in the RMH group, 256 in the IMH group, and 741 in the NMH group). At biopsy, patients with RMH were younger, had lower median proteinuria, a lower incidence of hypertension, and a higher estimated glomerular filtration rate than those in the NMH group. Pathologically, patients with RMH had a lower level of mesangial hypercellularity and segmental glomerulosclerosis as well as less tubular atrophy than those with NMH. The demographic and clinical features of patients with IMH fell between patients with RMH and those with NMH. During a median follow-up of 7.9 years, the 5-, 10- and 20-year cumulative renal survival after biopsy, as calculated by K-M methods, were 98, 91, and 91% in the RMH group, 95, 89, and 64% in the IMH group, and 95, 79, and 57% in the NMH group. The renal survival in patients with RMH was significantly better than patients with NMH or IMH.
  
  
  CONCLUSIONS
  The long-term prognosis of patients who present with RMH is significantly better than patients with NMH or IMH.
authors.affiliation: National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: WeiBo
authors.initials: W
authors.lastname: Le
authors.forename: ShaoShan
authors.initials: S
authors.lastname: Liang
authors.forename: Hao
authors.initials: H
authors.lastname: Chen
authors.forename: ShaoFan
authors.initials: S
authors.lastname: Wang
authors.forename: WenZhen
authors.initials: W
authors.lastname: Zhang
authors.forename: Xia
authors.initials: X
authors.lastname: Wang
authors.forename: JinQuan
authors.initials: J
authors.lastname: Wang
authors.forename: Cai-Hong
authors.initials: CH
authors.lastname: Zeng
authors.forename: Zhi-Hong
authors.initials: ZH
authors.lastname: Liu
mesh_terms: D000328:Adult; D001284:Atrophy; D016022:Case-Control Studies; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D005922:Glomerulonephritis, IGA / Q000150:complications* / Q000473:pathology / Q000652:urine; D006417:Hematuria / Q000209:etiology*; D006801:Humans; D006973:Hypertension / Q000150:complications; D007668:Kidney / Q000473:pathology*; D007676:Kidney Failure, Chronic / Q000209:etiology*; D007684:Kidney Tubules / Q000473:pathology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011507:Proteinuria / Q000209:etiology; D012008:Recurrence; D012042:Registries; D055815:Young Adult