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Prevalence of haematuria positively associated with urine albumin excretion in Type 2 diabetes
Author(s) -
Shen F.C.,
Lee C.T.,
Sun C.K.,
Chung M.S.,
Lee J.J.,
Chang H.W.,
Hsieh C.J.,
Yang K. D.,
Liu R.T.
Publication year - 2012
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2012.03608.x
Subject(s) - medicine , microalbuminuria , urinalysis , urine , albuminuria , creatinine , urology , odds ratio , type 2 diabetes , albumin , diabetes mellitus , urine collection device , excretion , urinary system , proteinuria , endocrinology , gastroenterology , renal function , kidney
Diabet. Med. 29, 1178‐1183 (2012) Abstract Aims Some guidelines or studies consider haematuria an indication for renal biopsy or a potential cause of albuminuria that precludes accurate assessment of urinary albumin excretion. This study examined the justification of excluding haematuria in interpreting urinary albumin excretion in patients with Type 2 diabetes and its associations with other diabetes‐related variables. Methods Between May and November 2008, patients with Type 2 diabetes at a single centre with data on urinary albumin excretion and urinalysis in the same urine sample were recruited. Urinary albumin excretion was determined by urine albumin/creatinine ratio in spot urine. Diagnosis of haematuria was made by positive urine occult blood from 1+ to 4+ and/or presence of more than nine red blood cells/ml in urinalysis. Demographic, anthropometric, clinical and laboratory variables and diabetes‐associated complications were analysed. Results In total, 743 patients were enrolled. Prevalence of haematuria among patients with normoalbuminuria, microalbuminuria, or macroalbuminuria was 8.7% ( n = 13), 16.1% ( n = 67) and 35.8% ( n = 64), respectively. Urine albumin/creatinine ratio was significantly higher, while macroalbuminuria was more common in patients with haematuria ( n = 144) than in those without ( n = 599). Multiple regression analysis identified urine albumin/creatinine ratio (odds ratio 1.33, P = 0.01) and macroalbuminuria (odds ratio 2.66, P = 0.01) as the only independent predictors of haematuria. Moreover, urine albumin/creatinine ratio was an independent predictor of haematuria in the macroalbuminuria subgroup (odds ratio 1.30, P = 0.04). Conclusions Increased urine albumin/creatinine ratio and macroalbuminuria were the only independent predictors of haematuria in patients with Type 2 diabetes, raising questions on the justifications of excluding haematuria in interpreting urinary albumin excretion in patients with Type 2 diabetes and including haematuria as an indication for renal biopsy in those with macroalbuminuria.