[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.
Matsumura
N
N
First Department of Internal Medicine, Nara Medical University, Japan.
Hanatani
M
M
Nishino
T
T
Ishihara
K
K
Kishimoto
T
T
Tonomura
Y
Y
Shiiki
H
H
Kanauchi
M
M
Dohi
K
K
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