预测镜下血尿患者一般肾脏疾病，尤其是肾小球肾炎的相关变量。

Variables to Predict Nephrological Disease in General, and Glomerulonephritis in Particular, in Patients With Microhematuria.

作者信息

Bramlage Carsten Paul, Wallbach Manuel, Ellenberger David, Deutsch Cornelia, Minguet Joan, Smith Katherine Helen, Stock Johanna, Goninski Alina, Bramlage Peter, Koziolek Michael, Mueller Gerhard Anton

机构信息

Department of Nephrology and Rheumatology, Georg-August-University of Gottingen, Gottingen, Germany.

Institute of Pharmacology and Preventive Medicine (IPPMED), Cloppenburg, Germany.

出版信息

J Clin Med Res. 2017 Jul;9(7):560-566. doi: 10.14740/jocmr2993w. Epub 2017 May 22.

DOI:10.14740/jocmr2993w

PMID:28611855

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5458652/

Abstract

BACKGROUND

Microhematuria (MH) is a symptom frequently leading to uncertainty as to when a nephrology referral is appropriate. Because MH may be indicative of severe kidney disorders, prompt diagnosis and potential treatment initiation can be important. We aimed to identify further variables that point at a nephrological cause, in particular of glomerulonephritis (GN), when MH is diagnosed.

METHODS

A retrospective analysis of data acquired from patients attending a nephrology office due to MH was performed. Demographic information and diagnostic tests were evaluated in order to identify factors that were associated with a nephrological cause.

RESULTS

Patients with MH (n = 805) as indicated by a urine stick analysis were included. Of these, MH was confirmed by urine sediment analysis in 543 patients (67.5%). Of those, 48.3% had a nephrological cause, including 12.4% with GN and 2.9% with rapid progressive GN (RPGN). A urine dipstick finding of ≥ 250 erythrocytes per microliter, microalbuminuria and elevated leukocytes increased the probability of having a GN to 62.4%. Furthermore, the presence of microalbuminuria, GFR < 60 mL/min, history of hypertension and diabetes mellitus increased the probability for all nephrological causes to 95.4%.

CONCLUSION

There are a number of factors available that help to assess the need for a nephrology referral in patients with microhematuria.

摘要

背景

镜下血尿（MH）是一种常导致何时进行肾脏科转诊存在不确定性的症状。由于MH可能提示严重的肾脏疾病，及时诊断并启动潜在治疗可能很重要。我们旨在确定在诊断MH时，能进一步指向肾脏病因，特别是肾小球肾炎（GN）的变量。

方法

对因MH就诊于肾脏科门诊的患者所获取的数据进行回顾性分析。评估人口统计学信息和诊断检查，以确定与肾脏病因相关的因素。

结果

纳入尿试纸分析提示有MH的患者（n = 805）。其中，543例患者（67.5%）经尿沉渣分析确诊为MH。其中，48.3%有肾脏病因，包括12.4%患有GN，2.9%患有急进性肾小球肾炎（RPGN）。尿试纸检测结果每微升≥250个红细胞、微量白蛋白尿和白细胞升高使患GN的概率增至62.4%。此外，微量白蛋白尿、肾小球滤过率（GFR）<60 mL/min、高血压病史和糖尿病史使所有肾脏病因的概率增至95.4%。