Clinical and pathological analysis of renal damage in elderly patients with type 2 diabetes mellitus

Abstract

The aim of this study was to investigate the causes and influential factors of renal damage in elderly patients with type 2 diabetes mellitus (T2DM). Clinical data and pathological findings at autopsy of 161 elderly T2DM patients died between October 1994 and August 2011 were retrospectively reviewed. The mean age of these patients was 80.8 ± 8.3 years (range 60-105 years). The incidences of diabetic nephropathy (DN), non-diabetic renal diseases (NDRD), and DN complicated with NDRD were 31.1, 62.7, and 16.2 %, respectively. In patients with NDRD, the incidence of hypertensive renal damage (HRD) was 54.7 %. In the factors causing renal damage, DN and NDRD accounted for 1/3 and 2/3, respectively. HRD accounted for the largest proportion of NDRD. Blood pressure control may provide additional benefits for elderly T2DM patients by preventing and delaying the occurrence and development of renal disease.

Validity of a Minimally Invasive Autopsy for Cause of Death Determination in Adults in Mozambique: An Observational Study

“…Diagnosis of such entities, however, remains challenging even with the CDA due to the variety of lesions and organs involved. These cases often require a combination of all the macroscopic data available and frequently the clinical information, which was not used in our study, to complete the non-conclusive pathological results [24–26]. …”

The modern spectrum of biopsy-proven renal disease in Chinese diabetic patients—a retrospective descriptive study

“…Furthermore, other studies of renal biopsy in DM have documented that non-diabetic renal disease (NDRD) plays a significant role in diabetic patients. The reported proportion of NDRD alone ranges from 18.1%–82.9% ( Pavkov et al, 2012 ; Byun et al, 2013 ; Sharma et al, 2013 ; Zhuo et al, 2013 ; Horvatic et al, 2014 ; Zwi et al, 2014 ; Klessens et al, 2016 ; Laranjinha et al, 2016 ; Liu et al, 2016 ; Liu, Tian & Jian, 2016 ) in diabetic patients with renal disease, while that of NDRD superimposed on DN ranges from 7.8%–48.9% ( Oh et al, 2012 ; Pavkov et al, 2012 ; Byun et al, 2013 ; Zhuo et al, 2013 ; Horvatic et al, 2014 ; Zwi et al, 2014 ; Klessens et al, 2016 ; Laranjinha et al, 2016 ; Liu et al, 2016 ; Liu, Tian & Jian, 2016 ). It is suggested that the absence of histopathologic evaluation may lead to a relatively high proportion of NDRD that were misdiagnosed as DN among diabetic patients.…”

“…However, most of the previous studies are from Western countries, where the spectrum of renal disease is different from that in China. There are only a few small-sampled, single-centered studies explaining the clinicopathological characteristics of DM related kidney disease in China ( Zhuo et al, 2013 ; Liu et al, 2016 ; Liu, Tian & Jian, 2016 ). To date, comprehensive data on renal biopsy findings in Chinese diabetic patients are lacking.…”

Peer Review #1 of "The modern spectrum of biopsy-proven renal disease in Chinese diabetic patients—a retrospective descriptive study (v0.1)"

“…Furthermore, Other studies of renal biopsy in DM have documented that non-diabetic renal disease (NDRD) plays a significant role in diabetic patients. The reported proportion of NDRD alone ranges from 18.1%-82.9% (Pavkov et al, 2012;Byun et al, 2013;Sharma et al, 2013;Zhuo et al, 2013;Horvatic et al, 2014;Zwi et al, 2014;Klessens et al, 2016;Laranjinha et al, 2016;Liu, Tian & Jian, 2016) in diabetic patients with renal disease, while that of NDRD superimposed on DN ranges from 7.8%-48.9% (Oh et al, 2012;Pavkov et al, 2012;Byun et al, 2013;Zhuo et al, 2013;Horvatic et al, 2014;Zwi et al, 2014;Klessens et al, 2016;Laranjinha et al, 2016;Liu, Tian & Jian, 2016). It is suggested that the absence of histopathologic evaluation may lead to a relatively high proportion of NDRD that were misdiagnosed as DN among diabetic patients.…”

“…However, most of the previous studies are from western countries, where the spectrum of renal disease is different from that in China. There are only a few small-sampled, single-centered studies explaining the clinicopathological characteristics of DM related kidney disease in China (Zhuo et al, 2013;Liu, Tian & Jian, 2016). To date, comprehensive data on renal biopsy findings in Chinese diabetic patients are lacking.…”