title: Dysmorphic erythrocytes are superior to hematuria for indicating non-diabetic renal disease in type 2 diabetics.
abstract: OBJECTIVE
  There are sparse and limited studies on erythrocyte morphology in renal biopsy identifying nephropathic patients among type 2 diabetics. The present study sought to clarify the predictive value of dysmorphic erythrocytes in type 2 diabetics with non-diabetic renal disease and influences on hematuria.
  
  
  METHODS
  We examined 198 patients with type 2 diabetes who underwent kidney biopsies between 2012 and 2013. Hematuria was defined as >3 or >10 red blood cells per high-power field (RBCs/hpf) in urine sediment. If >80% of the erythrocytes were dysmorphic, glomerular hematuria was diagnosed. Clinical findings and predictive value of dysmorphic erythrocytes were compared between patients with hematuria (n = 19) and those without (n = 61). The potential risk factors for hematuria among diabetic nephropathy patients were also screened.
  
  
  RESULTS
  There was a statistically significant difference between the diabetic nephropathy group and the non-diabetic renal disease group (6.6 vs 16.8%; P = 0.04) when the demarcation point of hematuria was 10 RBCs/hpf. When the definition of hematuria was based on an examination of urinary erythrocyte morphology, a marked difference was seen (3.3 vs 24.8%; P < 0.001). Glomerular hematuria showed high specificity and a positive predictive value (0.97 and 0.94, respectively) in non-diabetic renal disease. A multivariate analysis showed that nephrotic syndrome was significantly associated with hematuria (odds ratio 3.636; P = 0.034).
  
  
  CONCLUSIONS
  Dysmorphic erythrocytes were superior to hematuria for indicating non-diabetic renal disease in type 2 diabetics. Nephrotic syndrome was an independent risk factor for hematuria.
authors.affiliation: Department of Nephrology Chinese PLA General Hospital Chinese PLA Institute of Nephrology State Key Laboratory of Kidney Diseases National Clinical Research Center of Kidney Diseases Beijing China.
authors.forename: Zhe-yi
authors.initials: ZY
authors.lastname: Dong
authors.affiliation: Department of Nephrology Chinese PLA General Hospital Chinese PLA Institute of Nephrology State Key Laboratory of Kidney Diseases National Clinical Research Center of Kidney Diseases Beijing China.
authors.forename: Yuan-da
authors.initials: YD
authors.lastname: Wang
authors.affiliation: Department of Nephrology Chinese PLA General Hospital Chinese PLA Institute of Nephrology State Key Laboratory of Kidney Diseases National Clinical Research Center of Kidney Diseases Beijing China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Qiu
authors.affiliation: Department of Nephrology Chinese PLA General Hospital Chinese PLA Institute of Nephrology State Key Laboratory of Kidney Diseases National Clinical Research Center of Kidney Diseases Beijing China.
authors.forename: Kai
authors.initials: K
authors.lastname: Hou
authors.affiliation: Department of Nephrology Chinese PLA General Hospital Chinese PLA Institute of Nephrology State Key Laboratory of Kidney Diseases National Clinical Research Center of Kidney Diseases Beijing China.
authors.forename: Li
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Nephrology Chinese PLA General Hospital Chinese PLA Institute of Nephrology State Key Laboratory of Kidney Diseases National Clinical Research Center of Kidney Diseases Beijing China.
authors.forename: Jie
authors.initials: J
authors.lastname: Wu
authors.affiliation: Department of Nephrology Chinese PLA General Hospital Chinese PLA Institute of Nephrology State Key Laboratory of Kidney Diseases National Clinical Research Center of Kidney Diseases Beijing China.
authors.forename: Han-yu
authors.initials: HY
authors.lastname: Zhu
authors.affiliation: Department of Nephrology Chinese PLA General Hospital Chinese PLA Institute of Nephrology State Key Laboratory of Kidney Diseases National Clinical Research Center of Kidney Diseases Beijing China.
authors.forename: Guang-yan
authors.initials: GY
authors.lastname: Cai
authors.affiliation: Department of Nephrology Chinese PLA General Hospital Chinese PLA Institute of Nephrology State Key Laboratory of Kidney Diseases National Clinical Research Center of Kidney Diseases Beijing China.
authors.forename: Xue-feng
authors.initials: XF
authors.lastname: Sun
authors.affiliation: Department of Nephrology Chinese PLA General Hospital Chinese PLA Institute of Nephrology State Key Laboratory of Kidney Diseases National Clinical Research Center of Kidney Diseases Beijing China.
authors.forename: Xue-guang
authors.initials: XG
authors.lastname: Zhang
authors.affiliation: Department of Nephrology Chinese PLA General Hospital Chinese PLA Institute of Nephrology State Key Laboratory of Kidney Diseases National Clinical Research Center of Kidney Diseases Beijing China.
authors.forename: Mo-yan
authors.initials: MY
authors.lastname: Liu
authors.affiliation: Department of Nephrology Chinese PLA General Hospital Chinese PLA Institute of Nephrology State Key Laboratory of Kidney Diseases National Clinical Research Center of Kidney Diseases Beijing China.
authors.forename: Jia
authors.initials: J
authors.lastname: Kou
authors.affiliation: Department of Nephrology Chinese PLA General Hospital Chinese PLA Institute of Nephrology State Key Laboratory of Kidney Diseases National Clinical Research Center of Kidney Diseases Beijing China.
authors.forename: Xiang-mei
authors.initials: XM
authors.lastname: Chen
mesh_terms: D000328:Adult; D048430:Cell Shape / Q000502:physiology*; D002681:China / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D003928:Diabetic Nephropathies / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D004912:Erythrocytes / Q000378:metabolism* / Q000473:pathology*; D005260:Female; D006417:Hematuria / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D007674:Kidney Diseases / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D008875:Middle Aged
keywords: Hematuria; Nephropathy; Type 2 diabetics
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