Association between dipstick hematuria and decline in estimated glomerular filtration rate among Japanese patients with type 2 diabetes: A prospective cohort study [Diabetes Distress and Care Registry at Tenri (DDCRT 14)]

J Diabetes Complications. 2017 Jul;31(7):1079-1084. doi: 10.1016/j.jdiacomp.2017.04.016. Epub 2017 Apr 18.

Abstract

Aims: To assess the association between dipstick hematuria and estimated glomerular filtration rate (eGFR) decline in Japanese patients with type 2 diabetes.

Methods: Longitudinal data were obtained from 3068 Japanese patients with type 2 diabetes. To assess the independent association between dipstick hematuria and eGFR decline, we used Cox proportional hazard model adjusted for potential confounders.

Results: Median follow-up period was 699.7days. Mean age, body mass index (BMI), and HbA1c level were 65.7years, 24.6kg/m2, and 7.5% (58.1mmol/mol), respectively. Positive dipstick hematuria was significantly associated with baseline eGFR and severity of albuminuria (p<0.001). The multivariable-adjusted hazard ratio for eGFR decline in patients with dipstick hematuria compared with those without dipstick hematuria was 2.19 [95% confidence interval (CI): 1.22-3.91]; this association remained significant even after the exclusion of patients who did not have diabetic retinopathy (hazard ratio: 2.39; 95% CI: 1.13-5.04).

Conclusion: Positive dipstick hematuria was associated with severity of albuminuria and renal function. A significant association was found between dipstick hematuria and increased risk of eGFR decline among patients with type 2 diabetes. Therefore, our results suggest that dipstick hematuria is perhaps indicative of more severe diabetic nephropathy.

Keywords: Albuminuria; Diabetes; Diabetic nephropathy; Hematuria; eGFR decline.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Albuminuria / etiology*
  • Cohort Studies
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetic Nephropathies / physiopathology*
  • Diabetic Nephropathies / urine
  • Disease Progression
  • Female
  • Glomerular Filtration Rate
  • Hematuria / epidemiology
  • Hematuria / etiology*
  • Humans
  • Japan / epidemiology
  • Kidney / physiopathology*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Prevalence
  • Proportional Hazards Models
  • Prospective Studies
  • Reagent Strips
  • Registries
  • Renal Insufficiency / complications
  • Renal Insufficiency / physiopathology*
  • Renal Insufficiency / urine
  • Severity of Illness Index
  • Tertiary Care Centers

Substances

  • Reagent Strips