IgA Nephropathy Complicating Diabetic Glomerulosclerosis

Orfila, C; Lepert, Jean-Claude De; Modesto, Anne; Pipy, Bernard; Suc, J. M.

doi:10.1159/000045050

Cited by 29 publications

(23 citation statements)

References 24 publications

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“…Moreover, IgA nephropathy was found to be the commonest NDRD in other studies. 20,21 But other studies 15,17 showed that crescentic glomerulonephritis or acute tubulointerstitial nephritis and postinfectious glomerulonephritis were the commonest NDRD. Several observations suggest that common occurrence of IgA nephropathy in diabetic patients is not coincidental.…”

Section: Discussionmentioning

confidence: 99%

“…Several observations suggest that common occurrence of IgA nephropathy in diabetic patients is not coincidental. [20][21][22] Diabetic itself by affecting either glomerular structure and functioning and/or nonenzymatic glycation of immunoglobulin may facilitate the development of immunopathological alterations. 23 In support of this notion, superimposed IgA nephropathy on DN was associated with higher IgA levels when compared with DN alone.…”

Section: Discussionmentioning

confidence: 99%

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Nondiabetic Renal Disease in Type 2 Diabetic Patients: A Review of our Experience in 220 Cases

Nanlan

Ling

et al. 2011

Renal Failure

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Background: The purpose of this retrospective study was to evaluate the renal biopsies performed on type 2 diabetic patients for suspicion of nondiabetic renal disease (NDRD) and to correlate the pathological finding with the clinical and laboratory findings. Methods: From January 1999 to December 2009, 220 people with type 2 diabetes for clinically suspected NDRD underwent renal biopsy. The case records of these patients were retrospectively analyzed. Based on the biopsy findings, patients were divided into two groups: Group I, isolated diabetic glomerulosclerosis (DGS), and Group II, NDRD with underlying DGS. Clinical and laboratory data were analyzed in relation to the histopathological findings. Results: Of the 220 patients studied, 153 were males and 67 were females. The average age was 51.35 years (30-79). Renal biopsy showed that 100 patients (45.5%) had NDRD with underlying DGS. Group II had a significantly higher level of proteinuria and hematuria but less frequent diabetic retinopathy. There was no significant difference between the two groups in age, duration of diabetes, presence of hypertension, serum creatinine, and glomerular filtration rate. IgA nephropathy was the most common, accounting for 34% of Group II, membranous nephropathy ranked second accounting for 22.0%, followed by mesangial proliferative nephritis for 14%. Conclusion: This study showed that IgA nephropathy is the commonest NDRD among diabetics. The absence of retinopathy, especially when associated with nephritic proteinuria and hematuria, strongly predicts NDRD superimposed on DGS. Renal biopsy should be performed in diabetics when the clinical scenario is atypical.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Nondiabetic Renal Disease in Type 2 Diabetic Patients: A Review of our Experience in 220 Cases

Nanlan

Ling

et al. 2011

Renal Failure

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“…The pathogenesis of NDRD in diabetic patients is not clear. Some authors have suggested that the predisposition of DN to glomerulonephritis could be attributed to enhanced exposure of antigenic cellular components, triggering immune responses [36].…”

Section: Discussionmentioning

confidence: 99%

Spectrum of biopsy-proven renal diseases in patients with type 2 diabetes mellitus. A single center study

Wągrowska-Danilewicz

Danilewicz²

2015

pjp

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This is the first report from Poland documenting biopsy-proven renal diseases in type 2 diabetes mellitus. We analyzed the data of 76 patients with type 2 diabetes who underwent renal biopsy and were diagnosed in the Department of Nephropathology, Medical University of Lodz. The patients were divided into the following three groups according to the histological diagnosis: group I -isolated non-diabetic renal disease (NDRD); group II -NDRD superimposed on underlying diabetic nephropathy (NDRD + DN); and group III -isolated diabetic nephropathy (DN). Non-diabetic renal disease was found in 38 patients (50%), non-diabetic renal disease superimposed on underlying diabetic nephropathy was diagnosed in 11 patients (14.5%), and isolated diabetic nephropathy was seen in 27 patients (35.5%). The most common glomerular lesion found in groups I and II was focal segmental glomerulosclerosis (FSGS). On the basis of clinical and laboratory parameters, differentiating NDRD from DN in diabetic patients is not always obvious. However, our study revealed that hematuria, short duration of diabetes and the absence of diabetic retinopathy in type 2 diabetic patients manifesting renal involvement may suggest NDRD. The only way to distinguish NDRD from DN is histological evaluation of renal tissue.

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“…Primary glomerulonephritis, such as IgA nephropathy, has been reported to be superimposed on a background of diabetic glomerulosclerosis in patients with type 1 and 2 diabetes mellitus [25,26]. This could be a possibility in this reported case, though patient's diabetes mellitus was well-controlled (HbA1c 7%, no proteinuria, normal renal function and no diabetic retinopathy).…”

Section: Discussionmentioning

confidence: 70%

Crescentic IgA nephropathy following bone fracture

Karkar¹,

Ghacha²,

Abdelrahman³

2017

Nephrol Renal Dis

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Immunoglobulin A (IgA) nephropathy is the commonest form of primary glomerulonephritis with variable clinical presentation. It has been associated with several infectious and non-infectious diseases but with only few reported cases following traumatic bone fracture. The present case report describes a 55 years old male patient who developed acute kidney injury within 3 months following bone fracture. Urine examination showed microscopic haematuria and proteinuria together with rapid deterioration in renal function. Light microscopic examination of kidney biopsy sections showed glomerular mesangial proliferation with fibro-cellular crescent formation in few glomeruli, two glomeruli were sclerosed, in addition to interstitial inflammation and tubular atrophy. Immunofluorescence microscopy showed mesangial IgA and C3 deposits. The renal function improved substantially following a course of steroids and mycophenolate mofetil without dialysis support. The development of acute IgA nephropathy is possibly followed the incident of traumatic bone fracture.

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IgA Nephropathy Complicating Diabetic Glomerulosclerosis

Cited by 29 publications

References 24 publications

Nondiabetic Renal Disease in Type 2 Diabetic Patients: A Review of our Experience in 220 Cases

Nondiabetic Renal Disease in Type 2 Diabetic Patients: A Review of our Experience in 220 Cases

Spectrum of biopsy-proven renal diseases in patients with type 2 diabetes mellitus. A single center study

Crescentic IgA nephropathy following bone fracture

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