[The clinico-pathological significance of hematuria in diabetics].
A clinico-pathological study was performed on 154 patients with diabetes mellitus to clarify the significance of glomerular hematuria. Glomerular hematuria was observed in 26 patients (16.9%), of whom 10 had complications of IgA glomerulonephritis and one had membranous nephropathy. The remaining patients (143 cases) were divided into two groups; a hematuria group (15 cases) and a non-hematuria group (128 cases). Patients in the hematuria group showed diabetic retinopathy, hypertension, massive proteinuria and the requirement for insulin therapy more often than those in the non-hematuria group (p < 0.01, p < 0.001, p < 0.001 and p < 0.01, respectively). In addition, the serum creatinine level in the hematuria group was significantly elevated compared to that in the non-hematuria group (p < 0.01). Histologically, patients in the hematuria group exhibited advanced diffuse lesions, nodular lesions, exudative lesions, microaneurysms, crescent formation, capsular adhesion and interstitial lesions more often than those in the non-hematuria group (all, p < 0.001). Furthermore, the vascular index in the hematuria group was significantly higher than that in the non-hematuria group (p < 0.001). It is suggested that glomerular hematuria in diabetic patients indicates the presence of diabetic nephropathy at an advanced stage or coexistence of primary glomerulonephritis.
First Department of Internal Medicine, Nara Medical University, Japan.
N
N
Matsumura
M
M
Hanatani
T
T
Nishino
K
K
Ishihara
T
T
Kishimoto
Y
Y
Tonomura
H
H
Shiiki
M
M
Kanauchi
K
K
Dohi
D000293:Adolescent; D000328:Adult; D000368:Aged; D048909:Diabetes Complications; D003928:Diabetic Nephropathies / Q000150:complications; D005260:Female; D005921:Glomerulonephritis / Q000150:complications; D006417:Hematuria / Q000209:etiology*; D006801:Humans; D007668:Kidney / Q000473:pathology; D008297:Male; D008875:Middle Aged