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Manuel Praga - One of the best experts on this subject based on the ideXlab platform.

  • Glomerular Hematuria: Cause or Consequence of Renal Inflammation?
    MDPI AG, 2019
    Co-Authors: Juan Antonio Moreno, Manuel Praga, Ángel Sevillano, Eduardo Gutiérrez, Melania Guerrero-hue, Cristina Vázquez-carballo, Claudia Yuste, Carmen Herencia, Cristina García-caballero, Jesús Egido
    Abstract:

    Glomerular hematuria is a cardinal symptom of renal disease. Glomerular hematuria may be classified as Microhematuria or macrohematuria according to the number of red blood cells in urine. Recent evidence suggests a pathological role of persistent glomerular Microhematuria in the progression of renal disease. Moreover, gross hematuria, or macrohematuria, promotes acute kidney injury (AKI), with subsequent impairment of renal function in a high proportion of patients. In this pathological context, hemoglobin, heme, or iron released from red blood cells in the urinary space may cause direct tubular cell injury, oxidative stress, pro-inflammatory cytokine production, and further monocyte/macrophage recruitment. The aim of this manuscript is to review the role of glomerular hematuria in kidney injury, the role of inflammation as cause and consequence of glomerular hematuria, and to discuss novel therapies to combat hematuria

  • NEW INSIGHTS INTO FAMILIAL Microhematuria
    Current Opinion in Nephrology and Hypertension, 1999
    Co-Authors: Manuel Praga
    Abstract:

    The prevalence of familial persistent Microhematuria is probably higher than previously suspected. In recent years several studies have defined the commonest aetiologies and the clinical characteristics of this disorder, as well as the long-term evolution of these patients. The progressive knowledge of genes involved in the synthesis of type IV collagen, the main constituent of glomerular basement membrane, has provided new insights into molecular basis of thin basement membrane nephropathy and Alport's syndrome.

  • association of thin basement membrane nephropathy with hypercalciuria hyperuricosuria and nephrolithiasis
    Kidney International, 1998
    Co-Authors: Manuel Praga, Raquel Alegre, J C Herrero, Olga Novo, Julia Vara, Miguel Ángel Martínez, A Andres, Enrique Morales, J L Rodicio
    Abstract:

    Association of thin basement membrane nephropathy with hyper- calciuria, hyperuricosuria and nephrolithiasis. Background. Familial persistent Microhematuria with normal renal function is the most common presentation of thin basement membrane nephropathy (TBMN). Gross hematuria episodes and loin pain attacks are other manifestations of the disease. On the other hand, it has been shown that hypercalciuria (HC) and hyperuricosuria (HU) can produce both gross or microscopic non-glomerular hematuria, in addition to their role in renal stone formation. Methods. We studied the prevalence of HC, HU and nephroli- thiasis in a group of 27 biopsy-proven TBMN as well as in 19 non-biopsied first-degree relatives with persistent Microhematuria and 25 first-degree relatives without Microhematuria. A group of 27 patients with IgA nephropathy (IgAN) and persistent micro- hematuria, and another group of 20 healthy subjects without known renal diseases were selected as control groups. Results. Ten (37%) patients with TBMN and 8 (42%) relatives with Microhematuria showed HC and/or HU at presentation; relatives without Microhematuria, IgAN patients and normal controls showed a significantly lower prevalence of HC and HU. The prevalence of previous nephrolithiasis among TBMN patients (25%) was significantly higher than in IgAN patients (3%; P , 0.05). Family history of nephrolithiasis was recorded in 14 (51%) of the 27 TBMN families, in contrast with 2 of 27 (7%) with IgAN and 1 of 20 (5%) in normal controls (P , 0.05). The prevalence of nephrolithiasis, gross hematuria bouts and loin pain episodes among TBMN patients and microhematuric relatives showing HC and/or HU at presentation (44%, 44% and 27%, respectively) were significantly higher than those of TBMN patients and microhematuric relatives with normal calcium and uric acid urinary excretions (10%, 7% and 3%, respectively; P , 0.05). At the end of follow-up (8.8 6 4.1 years in TBMN patients and 9.1 6 4.2 years in relatives with Microhematuria), all the cases main- tained normal renal function. Conclusions. We found a high prevalence of HC, HU, and nephrolithiasis among TBMN patients and relatives with micro- hematuria. Our study also shows a significant relationship be- tween the presence of HC and/or HU and the prevalence of nephrolithiasis, gross hematuria bouts and loin pain episodes. Hypercalciuria (HC) and hyperuricosuria (HU) are im- portant lithogenic factors (1). In addition, several studies have showed that both metabolic disturbances can be associated with persistent microscopic hematuria in the absence of radiographically detectable calculi (2-11). When urinary calcium and uric acid are reduced by hydrochlo- rothiazide or allopurinol, respectively, hematuria resolves in most cases. We have observed several patients with persistent micro- hematuria associated with HC and/or HU in whom micro- hematuria persisted in spite of the treatment of these metabolic abnormalities. A later renal biopsy established the diagnosis of thin basement membrane nephropathy (TBMN) in most of them. These observations prompted us to review the history of all those patients diagnosed of TBMN at the Hospital Universitario 12 de Octubre. Our study shows a high prevalence of HC, HU and nephrolithi- asis among patients with TBMN and their families. Our findings also suggest that some clinical manifestations of the disease, such as episodes of gross hematuria and loin pain attacks, could be related to the presence of HC and/or HU.

J L Rodicio - One of the best experts on this subject based on the ideXlab platform.

  • association of thin basement membrane nephropathy with hypercalciuria hyperuricosuria and nephrolithiasis
    Kidney International, 1998
    Co-Authors: Manuel Praga, Raquel Alegre, J C Herrero, Olga Novo, Julia Vara, Miguel Ángel Martínez, A Andres, Enrique Morales, J L Rodicio
    Abstract:

    Association of thin basement membrane nephropathy with hyper- calciuria, hyperuricosuria and nephrolithiasis. Background. Familial persistent Microhematuria with normal renal function is the most common presentation of thin basement membrane nephropathy (TBMN). Gross hematuria episodes and loin pain attacks are other manifestations of the disease. On the other hand, it has been shown that hypercalciuria (HC) and hyperuricosuria (HU) can produce both gross or microscopic non-glomerular hematuria, in addition to their role in renal stone formation. Methods. We studied the prevalence of HC, HU and nephroli- thiasis in a group of 27 biopsy-proven TBMN as well as in 19 non-biopsied first-degree relatives with persistent Microhematuria and 25 first-degree relatives without Microhematuria. A group of 27 patients with IgA nephropathy (IgAN) and persistent micro- hematuria, and another group of 20 healthy subjects without known renal diseases were selected as control groups. Results. Ten (37%) patients with TBMN and 8 (42%) relatives with Microhematuria showed HC and/or HU at presentation; relatives without Microhematuria, IgAN patients and normal controls showed a significantly lower prevalence of HC and HU. The prevalence of previous nephrolithiasis among TBMN patients (25%) was significantly higher than in IgAN patients (3%; P , 0.05). Family history of nephrolithiasis was recorded in 14 (51%) of the 27 TBMN families, in contrast with 2 of 27 (7%) with IgAN and 1 of 20 (5%) in normal controls (P , 0.05). The prevalence of nephrolithiasis, gross hematuria bouts and loin pain episodes among TBMN patients and microhematuric relatives showing HC and/or HU at presentation (44%, 44% and 27%, respectively) were significantly higher than those of TBMN patients and microhematuric relatives with normal calcium and uric acid urinary excretions (10%, 7% and 3%, respectively; P , 0.05). At the end of follow-up (8.8 6 4.1 years in TBMN patients and 9.1 6 4.2 years in relatives with Microhematuria), all the cases main- tained normal renal function. Conclusions. We found a high prevalence of HC, HU, and nephrolithiasis among TBMN patients and relatives with micro- hematuria. Our study also shows a significant relationship be- tween the presence of HC and/or HU and the prevalence of nephrolithiasis, gross hematuria bouts and loin pain episodes. Hypercalciuria (HC) and hyperuricosuria (HU) are im- portant lithogenic factors (1). In addition, several studies have showed that both metabolic disturbances can be associated with persistent microscopic hematuria in the absence of radiographically detectable calculi (2-11). When urinary calcium and uric acid are reduced by hydrochlo- rothiazide or allopurinol, respectively, hematuria resolves in most cases. We have observed several patients with persistent micro- hematuria associated with HC and/or HU in whom micro- hematuria persisted in spite of the treatment of these metabolic abnormalities. A later renal biopsy established the diagnosis of thin basement membrane nephropathy (TBMN) in most of them. These observations prompted us to review the history of all those patients diagnosed of TBMN at the Hospital Universitario 12 de Octubre. Our study shows a high prevalence of HC, HU and nephrolithi- asis among patients with TBMN and their families. Our findings also suggest that some clinical manifestations of the disease, such as episodes of gross hematuria and loin pain attacks, could be related to the presence of HC and/or HU.

Ladan Zand - One of the best experts on this subject based on the ideXlab platform.

  • the association of Microhematuria with mesangial hypercellularity endocapillary hypercellularity crescent score and renal outcomes in immunoglobulin a nephropathy
    Nephrology Dialysis Transplantation, 2019
    Co-Authors: Shane A Bobart, Mariam P Alexander, Khaled Shawwa, Lisa E Vaughan, Ranine Ghamrawi, Sanjeev Sethi, Lynn D Cornell, Richard J Glassock, Fernando C Fervenza, Ladan Zand
    Abstract:

    BACKGROUND Microhematuria is common in immunoglobulin A nephropathy (IgAN). However, current prognostication is based on proteinuria and mesangial hypercellularity, endocapillary hypercellularity, segmental sclerosis, tubulointerstitial fibrosis and crescent (MEST-C) scores. METHODS In this retrospective study, we evaluated whether MEST-C score components are associated with the presence of Microhematuria at biopsy and whether the degree of Microhematuria during follow-up is associated with change in estimated glomerular filtration rate (eGFR), after adjusting for clinical and histological parameters. We identified 125 patients with biopsy-proven IgAN and MEST-C scoring who were not on immunosuppressive therapy at biopsy. Microhematuria was defined as ≥3 red blood cells (RBCs)/high-power field (hpf). RESULTS Of the 125 patients, 97 had Microhematuria at baseline and were more likely to have M1, E1 and C ≥ 1 lesions (P < 0.05 for all) compared with patients without Microhematuria. Of the 125 patients, 72 had follow-up data available. An increase in the degree of Microhematuria was significantly associated with an eGFR decline of -0.81 mL/min/1.73 m2 [95% confidence interval (CI) -1.44 to -0.19, P = 0.01], after adjusting for follow-up time, proteinuria and T score. Severe Microhematuria (≥21 RBCs/hpf) was associated with an even larger decline in eGFR (-3.99 mL/min/1.73 m2; 95% CI -6.9411 to -1.0552, P = 0.008), after similar adjustments. CONCLUSION Degree of Microhematuria during follow-up is an independent predictor of eGFR decline after adjusting for clinical and histological parameters. Therefore, monitoring the degree of Microhematuria as well as proteinuria is important when evaluating patients with IgAN. Additional studies using improvement in Microhematuria as a primary surrogate outcome are needed.

  • The association of Microhematuria with mesangial hypercellularity, endocapillary hypercellularity, crescent score and renal outcomes in immunoglobulin A nephropathy.
    Nephrology Dialysis Transplantation, 2019
    Co-Authors: Shane A Bobart, Mariam P Alexander, Khaled Shawwa, Lisa E Vaughan, Ranine Ghamrawi, Sanjeev Sethi, Lynn D Cornell, Richard J Glassock, Fernando C Fervenza, Ladan Zand
    Abstract:

    BACKGROUND Microhematuria is common in immunoglobulin A nephropathy (IgAN). However, current prognostication is based on proteinuria and mesangial hypercellularity, endocapillary hypercellularity, segmental sclerosis, tubulointerstitial fibrosis and crescent (MEST-C) scores. METHODS In this retrospective study, we evaluated whether MEST-C score components are associated with the presence of Microhematuria at biopsy and whether the degree of Microhematuria during follow-up is associated with change in estimated glomerular filtration rate (eGFR), after adjusting for clinical and histological parameters. We identified 125 patients with biopsy-proven IgAN and MEST-C scoring who were not on immunosuppressive therapy at biopsy. Microhematuria was defined as ≥3 red blood cells (RBCs)/high-power field (hpf). RESULTS Of the 125 patients, 97 had Microhematuria at baseline and were more likely to have M1, E1 and C ≥ 1 lesions (P 

Demetrius H Bagley - One of the best experts on this subject based on the ideXlab platform.

  • urolithiasis location and size and the association with Microhematuria and stone related symptoms
    Journal of Endourology, 2011
    Co-Authors: Costas D Lallas, Xiaolong S Liu, Allen Chiura, Akhil K Das, Demetrius H Bagley
    Abstract:

    Abstract Purpose: To conduct a study to assess the association between calculus location and size and the incidence of both Microhematuria and symptoms of urolithiasis in a urology office environment. Patients and Methods: After Institutional Review Board approval, a prospective study was conducted with data from 100 consecutive patients who presented to our office with documented urolithiasis. The location (caliceal, pelvic, or ureteral) and size (Microhematuria was ascertained via a urine dipstick and microscopic examination. The presence of any symptoms associated with urolithiasis, including pain, subjective fever or chills, or urinary urgency, was recorded. Results: A total of 111 stones were found in the study population resulting in a 45.9% incidence of Microhematuria. In patients with renal pelvic and ureteral stones, 67.6% demonstrated Microhematuria vs 36.4% with caliceal stones, P=0.0035. For ston...

  • Urolithiasis location and size and the association with Microhematuria and stone-related symptoms.
    Journal of Endourology, 2011
    Co-Authors: Costas D Lallas, Xiaolong S Liu, Allen Chiura, Akhil K Das, Demetrius H Bagley
    Abstract:

    Abstract Purpose: To conduct a study to assess the association between calculus location and size and the incidence of both Microhematuria and symptoms of urolithiasis in a urology office environment. Patients and Methods: After Institutional Review Board approval, a prospective study was conducted with data from 100 consecutive patients who presented to our office with documented urolithiasis. The location (caliceal, pelvic, or ureteral) and size (

Mehmet Okumus - One of the best experts on this subject based on the ideXlab platform.

  • correlation of volume position of stone and hydronephrosis with Microhematuria in patients with solitary urolithiasis
    Medical Science Monitor, 2013
    Co-Authors: Mehmet Fatih Inci, Fuat Ozkan, Selim Bozkurt, Mustafa Haki Sucakli, Bulent Altunoluk, Mehmet Okumus
    Abstract:

    BACKGROUND The aim of this study was to determine the relationship between hematuria and volume, position of stone, and hydronephrosis in patients with a solitary stone, using unenhanced multidetector computed tomography (MDCT). MATERIAL AND METHODS This retrospective study evaluated the clinical and radiological records of 83 patients undergoing MDCT for the evaluation of acute flank pain and suspected renal colic, who also underwent a microscopic urinalysis at the emergency department of our hospital during a 1-year period. Inclusion criteria of the MDCT study were solitary urolithiasis and cumulative stone diameter under 1 cm. RESULTS A total of 83 patients were included in the study, with a mean age of 42.1±14.4 years; 48 (57.8%) were females and 35 (42.2%) were males. Detection of 5 or more red cells on urinalysis was regarded as microscopic hematuria, and was positive in 46 patients (55.4%). There was a positive correlation between the position of the stone (especially upper two-thirds ureteral stones) and Microhematuria rate (r: 0.28, p=0.009). There was a statistically significant difference in presence of hydronephrosis between the Microhematuria (36 patients, 78%) and non-Microhematuria (12 patients, 32%) groups (p<0.001). The median stone volume between the Microhematuria and non-Microhematuria groups were not statistically different, 37.5 mm3 (range 5-425) and 28 mm3 (range 4-412), respectively (p=0.39). CONCLUSIONS Although stone volume is one of the best indicators of stone burden, it was not correlated with Microhematuria. However, in patients with renal colic, Microhematuria requires ultrasound examination whether hydronephrosis and ureteral stones are present or not. Further studies with larger sample sizes are warranted.

  • Correlation of volume, position of stone, and hydronephrosis with Microhematuria in patients with solitary urolithiasis
    Medical Science Monitor, 2013
    Co-Authors: Mehmet Fatih Inci, Fuat Ozkan, Selim Bozkurt, Mustafa Haki Sucakli, Bulent Altunoluk, Mehmet Okumus
    Abstract:

    BACKGROUND The aim of this study was to determine the relationship between hematuria and volume, position of stone, and hydronephrosis in patients with a solitary stone, using unenhanced multidetector computed tomography (MDCT). MATERIAL AND METHODS This retrospective study evaluated the clinical and radiological records of 83 patients undergoing MDCT for the evaluation of acute flank pain and suspected renal colic, who also underwent a microscopic urinalysis at the emergency department of our hospital during a 1-year period. Inclusion criteria of the MDCT study were solitary urolithiasis and cumulative stone diameter under 1 cm. RESULTS A total of 83 patients were included in the study, with a mean age of 42.1±14.4 years; 48 (57.8%) were females and 35 (42.2%) were males. Detection of 5 or more red cells on urinalysis was regarded as microscopic hematuria, and was positive in 46 patients (55.4%). There was a positive correlation between the position of the stone (especially upper two-thirds ureteral stones) and Microhematuria rate (r: 0.28, p=0.009). There was a statistically significant difference in presence of hydronephrosis between the Microhematuria (36 patients, 78%) and non-Microhematuria (12 patients, 32%) groups (p