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1. Diabet Med. 2012 Feb 7. doi: 10.1111/j.1464-5491.2012.03608.x. [Epub ahead of
print]

Prevalence of haematuria positively associated with urine albumin excretion in
Type 2 diabetes.

Shen FC, Lee CT, Sun CK, Chung MS, Lee JJ, Chang HW, Hsieh CJ, Yang KD, Liu RT.

Division of Metabolism Division of Nephrology, Department of Internal Medicine,
Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of
Medicine Department of Emergency Medicine, E-Da Hospital, I-Shou University
Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang
Gung University College of Medicine Department of Biological Sciences, National
Sun Yat-Sen University Department of Medical Research, Kaohsiung Chang Gung
Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung,
Taiwan.

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. © 2012 The Authors. Diabetic Medicine © 2012
Diabetes UK.

© 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK.

PMID: 22313158 [PubMed - as supplied by publisher]