Impact of hematuria on long term kidney outcomes in adults with immunoglobulin A nephropathy: a systematic literature review and meta-analysis.

What was studied

This review asked if blood in urine predicts kidney outcomes in IgA nephropathy. Hematuria is the most common sign of this disease. Its link to poor outcomes has not been clearly shown. The team searched PubMed/MEDLINE and Embase from January 2005 to June 2025. They looked at persistent or single-time tests for microhematuria or macrohematuria. Studies with similar outcome definitions were pooled.

What they found

15 study entries from 13 publications were pooled. Persistent microhematuria was consistently linked to worse kidney outcomes. Pooled microhematuria was linked to a higher risk of kidney failure or related outcomes. The hazard ratio was 2.33. For persistent microhematuria it was 2.57. A single test showed a nonsignificant link and varied across studies. Macrohematuria was linked to better kidney outcomes. Its hazard ratio was 0.56.

What it means for patients

They say persistent microhematuria is a strong, consistent predictor of kidney failure in IgAN. They say it is a clinically relevant prognostic marker.

Why it is not certain yet

Single-test results varied widely across studies. Macrohematuria was mostly measured at a single time point. Only studies with similar outcome definitions were pooled. The abstract does not say how good the studies were. A review can only be as good as the studies in it.

Source

Impact of hematuria on long term kidney outcomes in adults with immunoglobulin A nephropathy: a systematic literature review and meta-analysis.

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