title: Haematuria increases progression of advanced proteinuric kidney disease.
abstract: BACKGROUND
  Haematuria has been traditionally considered as a benign hallmark of some glomerular diseases; however new studies show that haematuria may decrease renal function.
  
  
  OBJECTIVE
  To determine the influence of haematuria on the rate of chronic kidney disease (CKD) progression in 71 proteinuric patients with advanced CKD (baseline eGFR <30 mL/min) during 12 months of follow-up.
  
  
  RESULTS
  The mean rate of decline in eGFR was higher in patients with both haematuria and proteinuria (haemoproteinuria, HP, n=31) than in patients with proteinuria alone (P patients, n=40) (-3.8±8.9 vs 0.9±9.5 mL/min/1.73 m2/year, p<0.05, respectively). The deleterious effect of haematuria on rate of decline in eGFR was observed in patients <65 years (-6.8±9.9 (HP) vs. 0.1±11.7 (P) mL/min/1.73 m2/year, p<0.05), but not in patients >65 years (-1.2±6.8 (HP) vs. 1.5±7.7 (P) mL/min/1.73 m2/year). Furthermore, the harmful effect of haematuria on eGFR slope was found patients with proteinuria >0.5 g/24 h (-5.8±6.4 (HP) vs. -1.37± 7.9 (P) mL/min/1.73 m2/year, p<0.05), whereas no significant differences were found in patients with proteinuria < 0.5 g/24 h (-0.62±7.4 (HP) vs. 3.4±11.1 (P) mL/min/1.73 m2/year). Multivariate analysis reported that presence of haematuria was significantly and independently associated with eGFR deterioration after adjusting for traditional risk factors, including age, serum phosphate, mean proteinuria and mean serum PTH (β=-4.316, p=0.025).
  
  
  CONCLUSIONS
  The presence of haematuria is closely associated with a faster decrease in renal function in advanced proteinuric CKD patients, especially in younger CKD patients with high proteinuria levels; therefore this high risk subgroup of patients would benefit of intensive medical surveillance and treatment.
authors.affiliation: Renal Unit. Gregorio Marañón Hospital, Madrid, Spain.
authors.forename: Claudia
authors.initials: C
authors.lastname: Yuste
authors.affiliation: Renal, Vascular and Diabetes Research Lab. IIS-Fundación Jiménez Díaz, Autonoma University, Madrid, Spain.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Rubio-Navarro
authors.affiliation: Renal Unit. Gregorio Marañón Hospital, Madrid, Spain.
authors.forename: Daniel
authors.initials: D
authors.lastname: Barraca
authors.affiliation: Renal Unit. Gregorio Marañón Hospital, Madrid, Spain.
authors.forename: Inés
authors.initials: I
authors.lastname: Aragoncillo
authors.affiliation: Renal Unit. Gregorio Marañón Hospital, Madrid, Spain.
authors.forename: Almudena
authors.initials: A
authors.lastname: Vega
authors.affiliation: Renal Unit. Gregorio Marañón Hospital, Madrid, Spain.
authors.forename: Soraya
authors.initials: S
authors.lastname: Abad
authors.affiliation: Renal Unit. Gregorio Marañón Hospital, Madrid, Spain.
authors.forename: Alba
authors.initials: A
authors.lastname: Santos
authors.affiliation: Renal Unit. Gregorio Marañón Hospital, Madrid, Spain.
authors.forename: Nicolás
authors.initials: N
authors.lastname: Macias
authors.affiliation: Department of Epidemiology. IIS-Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Mahillo
authors.affiliation: Department of Nephrology. Doce de Octubre Hospital, Madrid, Spain.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Gutiérrez
authors.affiliation: Department of Nephrology. Doce de Octubre Hospital, Madrid, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Praga
authors.affiliation: Renal, Vascular and Diabetes Research Lab. IIS-Fundación Jiménez Díaz, Autonoma University, Madrid, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain; Fundación Renal Iñigo Alvarez de Toledo-Instituto Reina Sofía de Investigaciones Nefrológicas (FRIAT-IRSIN), Madrid, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Egido
authors.affiliation: Renal Unit. Gregorio Marañón Hospital, Madrid, Spain.
authors.forename: Juan Manuel
authors.initials: JM
authors.lastname: López-Gómez
authors.affiliation: Renal, Vascular and Diabetes Research Lab. IIS-Fundación Jiménez Díaz, Autonoma University, Madrid, Spain.
authors.forename: Juan Antonio
authors.initials: JA
authors.lastname: Moreno
mesh_terms: D000368:Aged; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology; D006417:Hematuria / Q000473:pathology*; D006801:Humans; D007668:Kidney / Q000473:pathology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000473:pathology*; D051436:Renal Insufficiency, Chronic / Q000473:pathology* / Q000652:urine; D012189:Retrospective Studies; D012307:Risk Factors