Glomerular hematuria in diabetics.

Three hundred and twenty outpatients with diabetes mellitus (DM) were studied to evaluate the prevalence, origin (glomerular or nonglomerular), significance and possible association of glomerular hematuria (GH) with other clinical and laboratory features. In patients with 24 h proteinuria equal or superior to 500 mg, hematuria was seen in 16 out of 22 (72.7%); for those with 24 h proteinuria between 150 and 500 mg 5 out of 23 (21.7%) had hematuria, and in the general population of diabetics studied hematuria was present in 47 patients (14.7%). It was glomerular in 43 (13.4%) patients and nonglomerular in 4 (1.3%). Red blood cell casts were observed in 15 (34.9%) out of the 43 patients with GH. Ten out of 31 patients (32.3%) with GH, for whom 24 h proteinuria was available, had negative proteinuria in a 24 h urine when analyzed by routine methods. In 18 patients with GH, clinical and laboratory findings that could suggest a second form of glomerulopathy--nondiabetic--were negative. Renal biopsy in 9 of them showed only diabetic glomerulosclerosis. We have observed a significant association between GH and the male sex (p less than 0.001), high serum creatinine levels (p = 0.0002) and 24 h proteinuria greater than 150 mg (p less than 0.001). GH was more frequent among males with DM lasting more than 10 years (p less than 0.001) and among those with retinopathy (p less than 0.001). There was no association between GH and age, type of DM, insulin requirement or hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)