Waz W R, Quattrin T, Feld L G
Children's Hospital of Buffalo, NY 14222, USA.
J Diabetes Complications. 1995 Jul-Sep;9(3):194-7. doi: 10.1016/1056-8727(95)00036-2.
Hematuria is not described as a common finding in diabetic nephropathy, and may suggest nondiabetic renal disease. We reviewed the records of 59 children and adolescents with insulin-dependent diabetes mellitus referred to the Children's Kidney Center from 1983 to 1992. Fifty-two patients had clinical and/or biopsy evidence of diabetic nephropathy; 18/52 (35%) had microscopic hematuria at the time of referral. Patients with hematuria on presentation were referred for: hypertension (61%), proteinuria (61%), and decreased glomerular filtration rate (GFR) (11%). For patients without hematuria on presentation, reasons for referral included hypertension (79%), proteinuria (56%), and decreased GFR (3%). When comparing patients with and without hematuria, those with hematuria had a significantly longer duration of diabetes (12.8 +/- 3.1 versus 10.8 +/- 3.7 years, p < 0.05). The groups did not differ significantly with regard to age (18.3 +/- 1.8 versus 17.1 +/- 2.9 years), height (162.2 +/- 10.4 versus 159.3 +/- 11.3 cm), weight (63.9 +/- 10.9 versus 59.4 +/- 14.8 kg), systolic blood pressure (137.2 +/- 11.9 versus 133.2 +/- 13.2 mm Hg), diastolic blood pressure (85.6 +/- 7.6 versus 83.9 +/- 13.4 mm Hg), serum creatinine (1.0 +/- 0.18 versus 1.0 +/- 0.43 mg/dL), blood urea nitrogen (15 +/- 5 versus 13 +/- 4 mg/dL), glomerular filtration rate (117 +/- 34 versus 117 +/- 46 mL/min/1.73 m2), 24-h urine protein (2311 +/- 3862 versus 570 +/- 476 mg/day), or microalbuminuria (75 +/- 41 versus 34 +/- 35 micrograms/min). We detected a significant association between retinopathy and microscopic hematuria (sensitivity 47%, specificity 82%, p < 0.05), but no association between labstix proteinuria or sex and hematuria.(ABSTRACT TRUNCATED AT 250 WORDS)
血尿并非糖尿病肾病的常见表现，可能提示非糖尿病性肾脏疾病。我们回顾了1983年至1992年间转诊至儿童肾脏中心的59名胰岛素依赖型糖尿病儿童和青少年的病历。52例患者有糖尿病肾病的临床和/或活检证据；其中18/52（35%）在转诊时存在镜下血尿。出现血尿的患者转诊原因包括：高血压（61%）、蛋白尿（61%）和肾小球滤过率（GFR）下降（11%）。初诊时无血尿的患者，转诊原因包括高血压（79%）、蛋白尿（56%）和GFR下降（3%）。比较有血尿和无血尿的患者，有血尿的患者糖尿病病程显著更长（12.8±3.1年对10.8±3.7年，p<0.05）。两组在年龄（18.3±1.8岁对17.1±2.9岁）、身高（162.2±10.4厘米对159.3±11.3厘米）、体重（63.9±10.9千克对59.4±14.8千克）、收缩压（137.2±11.9毫米汞柱对133.2±13.2毫米汞柱）、舒张压（85.6±7.6毫米汞柱对83.9±13.4毫米汞柱）、血清肌酐（1.0±0.18毫克/分升对1.0±0.43毫克/分升）、血尿素氮（15±5对13±4毫克/分升）、肾小球滤过率（117±34对117±46毫升/分钟/1.73平方米）、24小时尿蛋白（2311±3862对570±476毫克/天）或微量白蛋白尿（75±41对34±35微克/分钟）方面无显著差异。我们发现视网膜病变与镜下血尿之间存在显著关联（敏感性47%，特异性82%，p<0.05），但试纸法蛋白尿或性别与血尿之间无关联。（摘要截取自250字）
