Introduction: In patients with diabetes mellitus (DM), non-diabetic renal disease (NDRD) can also occurs, as well as diabetic nephropathy. NDRD is most accurately diagnosed using kidney biopsy. Aim: The aim of the study was to investigate the incidence and type of NDRD diagnosed by kidney biopsy in patients with type 2 DM and the correlation of clinical and laboratory findings with histopathological diagnosis. Material and Methods: From April 2007 to October 2018, 290 kidney biopsies were performed at the Department of Nephrology, Internal Medicine Clinic in Banja Luka, out of which 18 patients (males 9, mean age 59.8 years) were with type 2 DM. The US-guided (ultrasound device: Toshiba Famio 5) kidney biopsy was performed using an automatic biopsy instrument FAST-GUN® with needle 16G. Kidney tissue samples were analyzed by light microscopy and immunofluorescence. Results: In 18 patients with type 2 DM, the average duration of the disease was 5.9 years, 5 patients had a retinopathy, and 16 patients had hypertension. Biopsy indications were: nephrotic syndrome in 11 patients, asymptomatic urinary abnormalities in 3 patients, and rapid chronic renal failure progression. Unsatisfactory quality sample for pathohistological analysis was obtained in one patient, and out of the other 17, 6 (35.3%) had NDRD, 3 (17.6%) had NDRD superimposed with the diabetic nephropathy, and 8 (47.1%) had diabetic nephropathy. Of the patients who had NDRD, 3 had membranous glomerulonephritis, 1 had focal segmental glomerulosclerosis, and two had hypertensive nephroangiosclerosis. Out of patients with coexisting NDRD and diabetic nephropathy, 2 had hypertensive nephroangiosclerosis and one diabetic nephropathy and lupus nephritis. Conclusion: NDRD was diagnosed using kidney biopsy in 9/17 patients with type 2 DM, which confirms the significance of the kidney biopsy in patients with DM with properly indications. Accurate diagnosis provides disease specific treatment and thus significantly improves the long-term prognosis of the patient.

Kratak sadržajUvod. Bolesnici sa dijabetes melitusom mogu osim dijabetesne nefropatije da imaju i nedijabetesnu bolest bubrega koja se najbolje dokazuje biopsijom bubrega. Cilj rada je da se biopsijom bubrega utvrdi učestalost i vrsta nedijabetesne bolesti bubrega kod bolesnika sa dijabetesom.Metode. U periodu od aprila 2007. do maja 2013. godine urađeno je devet biopsija (dva muškarca) bubrega kod bolesnika sa dijabetesom na Odjelu za nefrologiju Klinike za unutrašnje bolesti KC Banja Luka. Prosjek trajanja dijabetesa je bio 4,9 godina, retinopatiju je imao jedan, a hipertenziju sedam bolesnika. Biopsija je rađena biopsijskim pištoljem Fast Gun sa iglom promjera 16G, pod kontrolom ultrazvuka (Toshiba Famio 5 sa sondom vodilicom). Uzimana su dva uzorka tkiva: za optičku mikroskopiju i imunofluorescenciju.Rezultati. Indikacije za biopsiju su bile: nefrotski sindrom kod šest bolesnika, asimptomatske urinarne abnormalnosti (perzistentna proteinurija i/ ili mikrohematurija) kod dva, sistemski lupus eritematodes kod jednog. Kod šest pacijenata je postavljena patohistološka dijagnoza dijabetesne nefropatije, dva pacijenta su imala kombinovano dijabetesnu nefropatiju sa drugom bolešću bubrega (jedan sa hipertenzivnom nefroangiosklerozom, a drugi sa lupus nefritisom) i jedan pacijent primarni membranozni glomerulonefritis.Zaključak. Biopsija bubrega kod naših devet bolesnika sa dijabetesom je pokazala da su tri bolesnika (33,3%) imala nedijabetesnu bolest bubrega. Dva od tri bolesnika sa nedijabetesnom bolesti bubrega su imala glomerulsku, a jedan vaskularnu bolest bubrega (hipertenzivna nefroangioksleroza). Iako je uzorak bolesnika manji u poređenju sa studijama drugih autora, naša prva iskustva ukazuju da postoji značajan procenat bolesnika sa dijabetesom koji imaju nedijabetesnu bolest bubrega, što se sigurno može dokazati samo biosijom bubrega.

Breast cancer is a serious health problem. It is the most common cancer in women. The aim of this study was to estimate the concordance between ER, PR receptor and HER-2 immunohistochemistry assessment scores in pared CNB (core needle biopsy) and surgical specimens. Histological grade, oestrogen receptor (ER) status, progesterone receptor (PR) status, and human epidermal growth factor receptor-2 (HER2) status were evaluated in a blinded fashion in CNB and in surgical excision specimens. Absolute concordance rate between core needle biopsies and surgical specimens for histological grade was 50% with κ value (0,15) for ER 92% with κ value (0,79), PR 88% with κ value (0,73) and for HER2 96% with κ value (0,91). CNB can provide reliable information in evaluation of ER, PR and HER2 status in an invasive breast carcinoma.