Clinical and pathological characteristics of patients with asymptomatic glomerular hematuria and risk factors asso-ciated with renal lesions

AIM: To study the clinical and pathological characteristics of patients with asymptomatic glomerular hematuria and/or mild proteinuria and the clinical risk factors associated with the renal pathologic lesions.METHODS: 104 patients with asymptomatic glomerular hematuria and/or mild proteinuria(1.0 g/d or less) were collected from the inpatients who were diagnosed with primary chronic glomerulonephritis.All the patients underwent a renal biopsy for the pathological classifications.The patients were divided into 2 groups(mild renal lesion group and severe renal lesion group) according to the severity of renal pathologic lesions.The relationship between renal pathologic lesions and clinical factors was studied,and the predicted factors were analyzed using step-wise multiple variance regression analysis.RESULTS: Among these patients,13%(n=14) presented with pure proteinuria,30%(n=31) with isolated hematuria,and 57%(n=59) with both hematuria and proteinuria.The pathologic findings included: IgA nephropathy(n=63),constituting 60%,mesan-gial proliferative glomerulonephritis(n=20),accounting for 23%,minor glomerulonephritis change(n=15,15%),and focal segmental glomerulonephritis(3%).Proteinuria at the time of renal biopsy(OR=1.013,95%CI: 0.278-0.846,P=0.008) was an independent predictor of the severity of renal pathologic lesion.CONCLUSION: Patients with asymptomatic glomerular hematuria and/or mild proteinuria do not always present with mild pathologic lesions,IgA nephropathy is more common.Those with both hematuria and proteinuria have more severe renal lesions,and mild proteinuria is also associated with the severity of renal pathologic lesion.These patients should receive renal biopsy properly.