Correspondence |
Isolated microscopic haematuria
Sir,I read with interest the paper by Chow et al.1 (‘Long-term follow-up of patients with asymptomatic isolated microscopic haematuria’). The title of the paper is somewhat misleading, as in pure isolated microscopic haematuria, the urine protein excretion rate is <100 mg /day (<0.1 g /day),2 but in this study the authors also included patients with microscopic haematuria and minimal proteinuria (>0.2 g /day) and, as expected (as shown in Table 1 and Figure 2), the majority of the patients in the latter group had adverse events, because of the higher baseline protein excretion rate, possibly suggesting an underlying nephrological process. This paper re-iterates the well known fact that patients with minimal proteinuria are increased risk for disease progression.2 We shouldn't mix apples with oranges, and then conclude that a small amount of oranges would give apples a sour taste. The title ‘Long-term follow-up of patients with microscopic haematuria, with and without minimal proteinuria,’ might have been more appropriate for this paper, which highlights the significance of ‘even minimal proteinuria’ and the need for long-term follow-up of such patients.
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Northern Ontario School of Medicine Laurentian & Lakehead Univerisitiesr Timmins Canada e-mail: atbeat{at}ntl.sympatico.ca
References
1. Chow KM, Kwan BC, Li PK, Szeto CC. Asymptomatic isolated microscopic hematuria: long-term follow-up. Q J Med 2004; 97:739–45.
2. Kokko JP. Approach to the patient with renal disease. In: Goldman L, Bennett JC, eds. Cecile Textbook of Medicine, 21st edn. Saunders, 2000:528.
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