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Prevalence and causes of microscopic haematuria in Type 1 (insulin-dependent) diabetic patients with persistent proteinuria

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Summary

The prevalence and causes of microscopic haematuria were examined in all Type 1 (insulin-dependent) diabetic patients with persistent proteinuria (diabetes duration ⩾5 years) attending the outpatient clinic at Hvidöre Hospital during 1985. One hundred eighty-four patients (69F/115M) out of 1024 Type 1 patients had persistent proteinuria (18%). Microscopic haematuria was defined as ⩾3 erythrocytes per high power field in two or more sterile urine samples. Twenty-three Type 1 patients with persistent proteinuria (7F/16M, aged 35.4±13 years) had microscopic haematuria (12.5%). No significant changes were found between the group with and without microscopic haematuria: blood pressure 148/89±22/11 versus 145/91±20/11 mmHg, duration of diabetes when persistent albuminuria occurred 17±8 versus 20±10 years, serum creatinine 99±24 versus 98±31 μmol/l, simplex retinopathy 61 versus 54%, proliferative retinopathy 39 versus 42%, and no signs of retinopathy 0 versus 4%. Kidney biopsy was performed in 13 out of the 23 patients with microscopic haematuria. Diabetic glomerulosclerosis was present in all 13 patients, but 9 patients had a non-diabetic renal disease superimposed (mesangioproliferative glomerulonephritis (n=5), membranous glomerulonephritis (n=3) and sarcoidosis (n=1). Microscopic haematuria is a rare finding, frequently reflecting superimposed non-diabetic glomerulopathies, in Type 1 diabetic patients with diabetic nephropathy and well preserved kidney function.

References

  1. 1.

    Honey GE, Pryse-Davies J, Roberts DM (1962) A survey of nephropathy in young diabetics. Quart J Med 31: 473–483

  2. 2.

    Thomsen AaC (1965) The kidney in diabetes mellitus. Munksgaard, Copenhagen

  3. 3.

    Andersen AR, Christiansen JS, Andersen JK, Kreiner S, Deckert T (1983) Diabetic nephropathy in Type 1 (insulin-dependent) diabetes: an epidemiological study. Diabetologia 25: 496–501

  4. 4.

    Borch-Johnsen K, Andersen PK, Deckert T (1985) The effect of proteinuria on relative mortality in Type 1 (insulin-dependent) diabetes mellitus. Diabetologia 28: 590–596

  5. 5.

    Jones RH, Hayakawa H, Mackay JD, Parsons V, Watkins PJ (1979) Progression of diabetic nephropathy. Lancet 1: 1105–1106

  6. 6.

    Parving H-H, Andersen AR, Smidt UM, Svendsen PAa (1983) Early aggressive antihypertensive treatment reduces rate of decline in kidney function in diabetic nephropathy. Lancet 1: 1175–1179

  7. 7.

    O'Neill WM, Wallin JD, Walker PD (1983) Hematuria and red cell casts in typical diabetic nephropathy. Am J Med 74: 389–395

  8. 8.

    Hermann WH, Swartz RD (1985) Diabetic nephropathy and microscopic hematuria in Type 1 diabetes mellitus. Diabetic Nephropathy 4: 63–65

  9. 9.

    Mancini G, Carbonara AO, Heremans JF (1965) Immunochemical quantitation of antigens by single radial immunodiffusion. Immunochemistry 2: 235–254

  10. 10.

    Miles DW, Mogensen CE, Gundersen HJG (1970) Radioimmunoassay for urinary albumin using a single antibody. Scand J Clin Lab Invest 26: 5–11

  11. 11.

    Haeckel R (1980) Simplified determinations of the “true” creatinine concentration in serum and urine. J Clin Chem Clin Biochem 18: 385–394

  12. 12.

    WHO (1979) Report of a WHO Expert Committee on Hypertension. WHO Technical Report Series, Geneva

  13. 13.

    Larsen S (1978) Immunofluorescent microscopy findings in minimal or no change-disease and slight generalized mesangioproliferative glomerulonephritis. Acta Pathol Microbiol Scand 86: 531–542

  14. 14.

    Chung J, Sobin LH (1982) Renal disease, classification and atlas of glomerular disease. Igaku-Shoin, Tokyo, New York

  15. 15.

    Larsen S, Brun C (1979) Immune deposits in human glomeralopathy. Acta Pathol Microbiol Scand 87: 321–333

  16. 16.

    Thomsen OF (1972) Studies of diabetic glomerulosclerosis using an immunofluorescent technique. Acta Pathol Microbiol Scand 80: 193–200

  17. 17.

    Kasinath BS, Meyais SK, Spargo BH, Katz AJ (1983) Nondiabetic renal disease in patients with diabetes mellitus. Am J Med 75: 613–617

  18. 18.

    Carstens SA, Hebert LA, Garancis JC, Piering WF, Lemann J (1982) Rapidly progressive glomerulonephritis superimposed on diabetic glomerulosclerosis. JAMA 247: 1453–1457

  19. 19.

    Chihara J, Takebayashi S, Taguchi T, Yokoyama N, Harada T, Naito S (1986) Glomerulonephritis in diabetic patients and its effect on the prognosis. Nephron 43: 45–49

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Hommel, E., Carstensen, H., Skøtt, P. et al. Prevalence and causes of microscopic haematuria in Type 1 (insulin-dependent) diabetic patients with persistent proteinuria. Diabetologia 30, 627–630 (1987). https://doi.org/10.1007/BF00277319

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Key words

  • Microscopic haematuria
  • persistent proteinuria
  • diabetic glomerulosclerosis
  • non-diabetic glomerulopathy
  • Type 1 diabetes