CLINICAL AUDIT OF THE USE OF RENAL BIOPSY IN THE MANAGEMENT OF ISOLATED MICROSCOPIC HEMATURIA

Citation
Do. Mcgregor et al., CLINICAL AUDIT OF THE USE OF RENAL BIOPSY IN THE MANAGEMENT OF ISOLATED MICROSCOPIC HEMATURIA, Clinical nephrology, 49(6), 1998, pp. 345-348
Citations number
18
Categorie Soggetti
Urology & Nephrology
Journal title
ISSN journal
03010430
Volume
49
Issue
6
Year of publication
1998
Pages
345 - 348
Database
ISI
SICI code
0301-0430(1998)49:6<345:CAOTUO>2.0.ZU;2-A
Abstract
Whether renal biopsies are indicated for the investigation of microsco pic hematuria is a subject of debate. In this retrospective study we e valuated our use of renal biopsy in patients who presented between 198 5 and 1995 with microscopic hematuria but without proteinuria, hyperte nsion or renal insufficiency. Of 111 patients, 75 had a renal biopsy. Histological diagnoses included thin membrane nephropathy (TMN) (36%), IgA nephropathy (IgAN) (23%), non-IgA mesangioproliferative glomerulo nephritis (MPGN) (9%), mild glomerular abnormalities (11%), focal glob al glomerulosclerosis (FGS) (4%) and normal (17%). After 85 patients h ad been followed for a mean of 43 months these were no deaths, 3 patie nts had proteinuria (IgAN 2, no biopsy 1), 1 had proteinuria and renal insufficiency (immune negative MPGN) and ii were hypertensive (TMN 3, IgAN 2, normal 2, FGS 1, no biopsy 3). Hematuria resolved in 23 patie nts. Only 1 1 patients were still attending the nephrology clinic and 27% of the patients who were advised to continue annual follow-up with family doctors had not done so. In summary, the information obtained from renal biopsy rarely altered clinical management. Hypertension dev eloped in 13% of the patients followed but it was not predicted by the biopsy result. Although a renal biopsy will usually be diagnostic it is difficult to justify in patients who have isolated microscopic hema turia.