Characterization of Diabetic Kidney Disease in 235 Patients: Clinical and Pathological Insights with or without Concurrent Non-Diabetic Kidney Disease

Abstract

BACKGROUND This study aimed to explore the clinical and pathological features of patients with diabetic kidney disease (DKD), with and without non-diabetic kidney disease (NDKD), through a retrospective analysis. The objective was to provide clinical insights for accurate identification.METHODS A retrospective analysis of 235 patients admitted to the Department of Nephrology at Hangzhou Hospital of Traditional Chinese Medicine was conducted between July 2014 and December 2022. These patients underwent renal biopsy and received a pathology-based diagnosis of DKD. They were categorized into the DKD group (93 cases) and the DKD + NDKD group (142 cases).RESULTS In the DKD group, nodular diabetic glomerulosclerosis was the most prevalent, accounting for 63% of cases. In the DKD + NDKD group, the predominant pathological types were coupled with acute and chronic tubulointerstitial lesions, and IgA nephropathy, accounting for 40.14% and 35.21%, respectively. Clinical correlation analysis revealed associations between glomerular grading, tubulointerstitial lesions, renal arteriolar vitelliform lesions, renal vascular atherosclerosis, and clinical parameters such as 24-hour urine protein, hemoglobin, and urinary specific gravity. Multifactorial logistic regression analysis identified independent factors affecting DKD + NDKD, including body mass index, blood creatinine level, microscopic erythrocyte grade, urinary immunoglobulin G/creatinine ratio, and serum immunoglobulin A.CONCLUSION This study provides important insights into the pathological and clinical features of DKD and identifies independent factors associated with DKD + NDKD.