Kritmetapak K, et al. - Patients with type 2 diabetes were assessed to determine the pathological features of nondiabetic renal disease (NDRD) and clinical parameters-based predictability of diagnosing NDRD [(±diabetic nephropathy (DN)] versus isolated DN. Approximately half of patients with atypical renal presentation had NDRD (±DN), as revealed via prudent use of renal biopsy. This finding was reported especially in male patients with well-controlled diabetes, those who have had diabetes for a short duration and those with active urinary sediment.

Methods

• Researchers performed a retrospective analysis of medical records of type 2 diabetes patients who underwent renal biopsy under suspicion of NDRD from January 2011 through November 2015.

Results

• This study included a total of 101 patients.
• Data showed that for renal biopsy, the most frequent indication was recent onset of nephrotic syndrome (41%), followed by rapidly progressive renal failure (29%) and active urinary sediment (21%).
• Renal biopsy detected isolated DN in 51% of patients, isolated NDRD in 20% and DN plus NDRD in 29%.
• IgA nephropathy was identified as the most common cause of isolated NDRD, whereas acute tubular necrosis (39%) and acute interstitial nephritis (33%) were the main causes of NDRD superimposed on DN.
• According to multiple logistic regression analysis, independent predictors of NDRD were: male gender, short-duration diabetes (<8 years), lower glycated hemoglobin and active urinary sediment (≥10 red and white blood cells per high-power field).