Aims/Introduction
:
There are sparse and limited studies on erythrocyte morphology
in renal biopsy identifying nephropathic pa
tients among type 2 diabetics. The present
study sought to clarify the predictive value of d
ysmorphic erythrocytes in type 2 diabetics
with non-diabetic renal diseas
e and influences on hematuria.
Materials and Methods
:
We examined 198 patients with type 2 diabetes who under-
went kidney biopsies between 2012 and 2013. Hematuria was defined as
>
3or
>
10 red
blood cells per high-power field (RBCs/hpf) in urine sediment. If
>
80% of the erythrocytes
were dysmorphic, glomerular hematuria was di
agnosed. Clinical findings and predictive
value of dysmorphic erythrocytes were com
pared 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 demar-
cation point of hematuria was 10 RBCs/hpf.
When the definition of hematuria was based
on an examination of urinary erythrocyte mor
phology, a marked difference was seen (3.3
vs 24.8%;
P
<
0.001). Glomerular hematuria showed hi
gh specificity and a positive predic-
tive value (0.97 and 0.94, respectively) in non-diabetic renal disease. A multivariate analysis
showed that nephrotic syndrome was signific
antly 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.