A LONG-TERM FOLLOW-UP-STUDY OF ASYMPTOMATIC HEMATURIA AND OR PROTEINURIA IN ADULTS/

Between January 1, 1983 and December 31, 1992, 805 patients with asymp tomatic proteinuria and/or hematuria were selected in the mass screeni ng of 56,269 adults. We conducted prospective long-term follow-up stud ies of these patients and evaluated their clinical findings and renal histology. They were divided into three groups according to the first dipstick urinalysis findings: 478 patients with pure hematuria (H), 15 0 patients with concomitant hematuria and proteinuria (H & P), and 177 patients with proteinuria (P). The mean follow-up period was 5.80 +/- 4.42 years. Of the 478 patients with H, a specific cause of hematuria was found in 46 (9.6%), the remaining 432 (90.4%) patients were diagn osed as having asymptomatic hematuria (ASH). During the follow-up peri od, in the ASH patients, hematuria disappeared in 44.2%, 43.7% had per sistent microhematuria without proteinuria, and 10.6% manifested prote inuria, none of the patients showed renal insufficiency. Of the 150 pa tients with H & P, 134 were diagnosed as having asymptomatic H & P. Du ring the follow-up period, the hematuria and proteinuria disappeared i n 16.4% of these patients, the proteinuria disappeared in 8.2%, and 14 .9% of the patients showed renal insufficiency. Of the 177 patients wi th P, 151 were diagnosed has having asymptomatic P. During the follow- up period, proteinuria disappeared in 23.2%, and 10.6% showed renal in sufficiency. Renal biopsy was performed in 151 patients in the study p opulation who had a moderate degree of proteinuria; 68.2% of these pat ients had IgA nephropathy, 12.6% had non-IgA mesangial proliferative G N, 6.0% had membranous nephropathy, 5.3% had minimal change, and 2.6% had focal and segmental glomerular sclerosis. This study of the mass s creening of urinalysis in asymptomatic adults showed that although the patients with pure hematuria did not exhibit renal insufficiency, 10. 6% of these patients were proteinuric during the follow-up period. The refore, careful observation and management are needed in these patient s.