title: The Natural Course of Biopsy-Proven Isolated Microscopic Hematuria: a Single Center Experience of 350 Patients.
abstract: The increasing interest in healthcare and health screening events is revealing additional cases of asymptomatic isolated microscopic hematuria (IMH). However, a consensus of the evaluation and explanation of the IMH prognosis is controversial among physicians. Here, we present the natural course of IMH together with the pathological diagnosis and features to provide supportive data when approaching patients with IMH. We retrospectively evaluated 350 patients with IMH who underwent a renal biopsy between 2002 and 2011, and the pathological diagnosis and chronic histopathological features (glomerulosclerosis, interstitial fibrosis, and tubular atrophy) were reviewed. Deterioration of renal function was examined during follow up. The patients with IMH were evaluated for a mean of 86 months. IgA nephropathy was the most common diagnosis in 164 patients (46.9%). Chronic histopathological changes were observed in 166 (47.4%) but was not correlated with proteinuria or a decline in renal function. Ten patients developed proteinuria, and all of them had IgA nephropathy. Three patients progressed to chronic kidney disease with an estimated glomerular filtration rate < 60 mL/min/1.73 m(2) but none progressed to end stage renal disease. In conclusion, IMH had a generally benign course during 7-years of observation, although IgA nephropathy should be monitored if it progresses to proteinuria. Future prospective randomized studies may help conclude the long-term prognosis and lead to a consensus for managing IMH.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea .
authors.forename: Hae Min
authors.identifier: 0000-0003-0131-1284
authors.initials: HM
authors.lastname: Lee
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea .
authors.forename: Ji In
authors.identifier: 0000-0001-8207-5302
authors.initials: JI
authors.lastname: Hyun
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea .
authors.forename: Ji-Won
authors.identifier: 0000-0001-6295-8095
authors.initials: JW
authors.lastname: Min
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea .
authors.forename: Kyungsoo
authors.identifier: 0000-0002-6781-0986
authors.initials: K
authors.lastname: Lee
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea .
authors.forename: Yong Kyun
authors.identifier: 0000-0002-1871-3549
authors.initials: YK
authors.lastname: Kim
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea .
authors.forename: Euy Jin
authors.identifier: 0000-0002-3124-7829
authors.initials: EJ
authors.lastname: Choi
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea .
authors.forename: Ho Cheol
authors.identifier: 0000-0002-9849-8091
authors.initials: HC
authors.lastname: Song
mesh_terms: D000293:Adolescent; D000328:Adult; D001706:Biopsy; D005260:Female; D005919:Glomerular Filtration Rate; D005922:Glomerulonephritis, IGA / Q000175:diagnosis; D006417:Hematuria / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D007668:Kidney / Q000473:pathology* / Q000502:physiology; D007676:Kidney Failure, Chronic / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011507:Proteinuria / Q000175:diagnosis; D012189:Retrospective Studies; D055815:Young Adult
keywords: Biopsy; Glomerulonephritis, IGA; Hematuria; Kidney; Kidney Failure, Chronic; Proteinuria