Acanthocyturia in diagnose of hematuria of the diabetic nephropathy, hypertensive nephropathy, and glomerulonephritis

Abstract

The presence of hematuria in diabetic and hypertensive patients has been thought to indicate other glomerulonephritides (GN) other than diabetic nephropathy (DN) or hypertensive nephropathy (HN). Renal biopsy should be obtained in such instances. Urinalysis by phase contrast microscopy (PCM) allows glomerular hematuria, which is defined as acanthocyturia >5%, to be differentiated from nonglomerular hematuria. The authors hypothesize that acanthocyturia is an uncommon finding in both DN and HN, its finding suggesting the presence of other glomerular disease. Urine samples of patients with a clinical diagnosis of DN (n=18) and of HN (n=16), of patients with biopsy-proven GN (n=25), and control subjects (n=43) were examined by PCM for the presence of hematuria and acanthocyturia. Glomerular hematuria was prevalent in DN, HN and GN relative to control subjects (p<0.05). However, acanthocyturia was prevalent only in GN (48%). In conclusion, acanthocyturia is uncommon in patients with clinically diagnosed DN and HN, but the finding of acanthocyturia >5% may be useful to differentiate DN and HN from other glomerular diseases.