The Significance of Hematuria in Primary Proteinuric Glomerular Disease Outcomes
Bibliographic record
Abstract
Background: Hematuria is associated with the incidence and progression of CKD. The study aims were to assess the prevalence of hematuria in a large cohort of proteinuric glomerular disease and assess the association between hematuria and kidney-related outcomes. Methods: Hematuria was assessed at first reported study urinalysis in patients with MN, MCD, and FSGS in NEPTUNE and CureGN cohorts with >24 months of follow-up. Hematuria was defined as small, moderate, or large blood on urinary dipstick and no hematuria was negative or trace blood. Multivariable Cox proportional hazards models were fit for time to composite outcome (ESKD or 40% decline in GFR and eGFR <60) and proteinuria remission (UPCR <0.3 mg/mg). Results: 1,108 adults and children were included. 412 (37%) patients had FSGS, 389 (36%) had MCD, and 307 (28%) had MN. 745 (67%) participants were positive for hematuria at first urinalysis. Those who had hematuria vs. those without at first urinalysis were more likely to have an underlying diagnosis of MN (37% vs 23%), be older (34 vs 25 years), have shorter time since biopsy (128 vs 315 days) and higher UPCR (3.6 vs 0.8). Patients with hematuria had higher rates of the composite outcome and lower rates of complete remission (Figure 1). After adjusting for diagnosis, age, sex, UPCR, eGFR, time since biopsy, and cohort, hematuria was associated with a higher hazard of reaching the composite outcome (HR 1.39 [1.05, 1.84], p-value 0.02) and lower hazard of reaching proteinuria remission (HR 0.71 [0.55-0.91], p-value 0.006). Conclusions: Hematuria is prevalent among patients with podocytopathic disease not classically considered nephritic. There was an independent association between hematuria and worse kidney related outcomes. The underlying mechanisms warrants further investigation and include genetic predisposition, structural alterations in the glomerular basement membrane, and tubular toxicity from heme pigment. Funding: NIDDK Support, Other NIH Support - NCATS
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".