Cross-sectional and longitudinal associations between dipstick hematuria and chronic kidney disease in patients with type 2 diabetes

• Published in: Diabetes research and clinical practice Vol. 172; p. 108519
• Main Authors: Yoshida, Noriko, Hanai, Ko, Murata, Hidekazu, Uchigata, Yasuko, Babazono, Tetsuya
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.02.2021
• Subjects: Albuminuria; Chronic kidney disease; Cross-Sectional Studies; Diabetes Mellitus, Type 2 - complications; Diabetic kidney disease; Diabetic nephropathy; Disease Progression; Female; GFR; Hematuria; Hematuria - etiology; Humans; Incidence; Longitudinal Studies; Male; Middle Aged; Renal Insufficiency, Chronic - complications; Diabetic nephropathy; GFR; Chronic kidney disease; Albuminuria; Hematuria; Diabetic kidney disease
• ISSN: 0168-8227; 1872-8227
• DOI: 10.1016/j.diabres.2020.108519

To examine the association of dipstick hematuria with kidney function and albuminuria in patients with type 2 diabetes (T2D). A total of 7,945 patients with T2D were studied. In the cross-sectional study, patients were classified into 6 groups based on the stage of albuminuria and estimated glomerular filtration rate (eGFR) of 60 mL/min/1.73 m2 at baseline. In the longitudinal study where patients were classified by the presence of hematuria, the primary composite endpoint was a 30% decrease in eGFR from baseline or the initiation of kidney replacement therapy. Other outcomes included eGFR slope and stage progression of albuminuria. Cross-sectionally, hematuria was more prevalent in patients with more advanced stages of albuminuria and with lower eGFR, independently of each other. In the longitudinal study, patients with hematuria experienced 50% increased incidence of the primary endpoint (p < 0.001). The eGFR slope was steeper in patients with hematuria than in those without hematuria (p < 0.001). On the other hand, hematuria was unlikely to be associated with the progression of albuminuria. In patients with T2D, dipstick hematuria was associated with prevalent albuminuria and reduced eGFR, as well as faster decline in kidney function but not higher risk of development or progression of albuminuria.