Haematuria as a risk factor for chronic kidney disease progression in glomerular diseases: A review

Pediatr Nephrol. 2016 Apr;31(4):523-33. doi: 10.1007/s00467-015-3119-1. Epub 2015 May 17.


Haematuria has long been considered to be a benign condition associated with glomerular diseases. However, new evidences suggest that haematuria has a pathogenic role in promoting kidney disease progression. An increased risk for end-stage renal disease has been reported in adolescents and young adults with persistent microscopic haematuria. A persistent impairment of renal function has been also reported following macroscopic haematuria-associated acute kidney injury in immunoglobulin A nephropathy. Haematuria-induced renal damage has been related to oxidant, cytotoxic and inflammatory effects induced by haemoglobin or haem released from red blood cells. The pathophysiological origin of haematuria may be due to a more fragile and easily ruptured glomerular filtration barrier, as reported in several glomerular diseases. In this review we describe a number of the key issues associated with the epidemiology and pathogenesis of haematuria-associated diseases, provide an update of recent knowledge on the role of haematuria on renal function outcome and discuss specific therapeutic approaches in this setting. KEY SUMMARY POINTS: 1. Glomerular haematuria is a common observation in a number of renal diseases that may lead to persistent renal injury. 2. Haematuria in children differs from that in adults in specific aspects, particularly in the frequency of glomerular diseases and renal disease outcome. 3. Regular follow-up of renal function in children with isolated microhaematuria may be recommended.

Keywords: Acute kidney injury; Chronic kidney disease; Glomerulonephritis; Haematuria; Red blood cells.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Disease Progression
  • Glomerulonephritis / complications*
  • Glomerulonephritis / diagnosis
  • Glomerulonephritis / physiopathology
  • Glomerulonephritis / therapy
  • Hematuria / diagnosis
  • Hematuria / etiology*
  • Hematuria / physiopathology
  • Hematuria / therapy
  • Humans
  • Kidney / physiopathology*
  • Kidney Failure, Chronic / etiology
  • Kidney Failure, Chronic / physiopathology
  • Kidney Failure, Chronic / prevention & control
  • Prognosis
  • Renal Insufficiency, Chronic / diagnosis
  • Renal Insufficiency, Chronic / etiology*
  • Renal Insufficiency, Chronic / physiopathology
  • Renal Insufficiency, Chronic / prevention & control
  • Risk Factors