Predicting non-diabetic renal disease in type 2 diabetic adults: The value of glycated hemoglobin

Pallayová, Mária; Mohammed, Azharuddin; Langman, Gerald; Taheri, Shahrad; Dasgupta, Indranil

doi:10.1016/j.jdiacomp.2014.12.005

Cited by 20 publications

(16 citation statements)

References 28 publications

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“…In a retrospective study of 51 T2DM patients, Pallayova et al showed that 35 (68.6%) patients had non-diabetic etiology. The most common diagnoses were interstitial nephritis (20%), progressive crescentic glomerulonephritis (14%), MN (11%) and FSGS (11%) [24]. In our study, according to the kidney biopsy findings, pure NDKD was detected in 50% of the patients.…”

Section: Discussionmentioning

confidence: 52%

“…Prakash and colleagues observed NDKD in 40% of cases with DR and DKD in 43% of the cases without DR, which suggested that the lack of DR did support NDKD, but it did not exclude DKD [16]. Pallayova and colleagues demonstrated that the predictors of NDKD in T2DM patients were absence of DR, lower HbA1c values 12 months before biopsy and greater deterioration in HbA1c prior to biopsy [24]. In our study, DR was found in 18 (37.5%) patients; 15 (75%) in the isolated DKD patient group, 2 (8.3%) in the isolated NDKD patient group, and 1 (25%) in the DKD+NDKD patient group.…”

Section: Discussionmentioning

confidence: 99%

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Non-Diabetic Kidney Disease in Type 2 Diabetic Patients: Prevalence, Clinical Predictors and Outcomes

Erdogmus

Kiremitci

Celebi

et al. 2017

Kidney Blood Press Res

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Background/Aims: Diabetic kidney disease (DKD) is one of the most frequent microvascular complications of diabetes and is the leading cause of end-stage kidney disease worldwide. In patients with diabetes, non-diabetic kidney disease (NDKD) can also occur. NDKD can be either alone or superimposed with the DKD. In this study, we aimed to investigate the utility of kidney biopsy in patients with type 2 diabetes mellitus (T2DM) and the predictability of diagnosing DKD versus NDKD from clinical and laboratory data. We also evaluated the prevalence and etiology of NDKD in patients with T2DM. Methods: We retrospectively reviewed type 2 diabetic patients who had kidney biopsy in the last 10 years for diagnosing possible NDKD in our center. In all patients kidney biopsies were performed because of atypical clinical features and biopsy samples were examined by light and immunofluorescence microscopy. Clinical parameters, laboratory workup and office blood pressures were recorded for each patient at the time of biopsy. Results: Eight patients were excluded due to missing data. A total of 48 patients (female/male: 26/22 and mean age: 59±8 years) were included in the study. According to the biopsy findings, 24 (50%) patients had NDKD alone, 20 (41.7%) had DKD alone and 4 (8.3%) had coexisting DKD and NDKD. The most common NDKD diagnoses were membranous nephropathy (29.2%), tubulointerstitial nephritis (20.8%) and IgA nephropathy (12.5%). There were no significant differences in three groups with respect to the duration of diabetes, proteinuria, hematuria and glycated hemoglobin A1c levels. Diabetic retinopathy (DR) was the most significant finding, which was associated with DKD. Positive and negative predictive values of DR for DKD were 88 and 81%, respectively. Conclusion: This study demonstrated a high prevalence of NDKD in patients with T2DM. The absence of DR strongly predicted NDKD. Clinical decision alone can lead to wrong diagnosis and delay in appropriate therapy. Clinicians should consider the kidney biopsy more liberally when there is uncertainty on the exact etiology of the kidney disease. However, prospective multicenter studies are needed to clarify the prognosis and outcomes of patients with diabetics.

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Section: Discussionmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Non-Diabetic Kidney Disease in Type 2 Diabetic Patients: Prevalence, Clinical Predictors and Outcomes

Erdogmus

Kiremitci

Celebi

et al. 2017

Kidney Blood Press Res

View full text Add to dashboard Cite

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“…However, it can sometimes be diffi cult to estimate exactly how long diabetes has been present as type 2 diabetes can remain asymptomatic for a number of years. The likelihood of nephropathy is greater if there has been a long period of poor glucose control [ 3 ].…”

Section: Is It Diabetic Nephropathy ?mentioning

confidence: 99%

“…Patients with diabetic nephropathy almost always have retinopathy [ 3 ] and often have cardiovascular or peripheral vascular disease.…”

Section: Is There Proteinuria or Haematuria?mentioning

confidence: 99%

Should We Do a Kidney Biopsy?

Rayner

Thomas

Milford

2015

Understanding Kidney Diseases

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“…As both of these parameters were separately predictive of non-diabetic etiology, the authors proposed a model based on the interaction between these two terms and which predicted non-diabetic etiology with 73.7% sensitivity and 75% specificity (AUC, 0.77; 95% CI, 0.59 to 0.94) (Pallayova et al, 2015). The study demonstrates that when carefully selected, diabetic patients with features atypical of DN have a high probability of having a non-diabetic etiology, but it remains to be seen if this model will work prospectively with comparable degree of sensitivity and specificity in predicting NDRD with in diabetics.…”

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confidence: 99%

Non-diabetic renal disease in diabetic patients: How to identify? When to biopsy?

Baudy

Batuman

2015

Journal of Diabetes and its Complications

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Predicting non-diabetic renal disease in type 2 diabetic adults: The value of glycated hemoglobin

Cited by 20 publications

References 28 publications

Non-Diabetic Kidney Disease in Type 2 Diabetic Patients: Prevalence, Clinical Predictors and Outcomes

Non-Diabetic Kidney Disease in Type 2 Diabetic Patients: Prevalence, Clinical Predictors and Outcomes

Should We Do a Kidney Biopsy?

Non-diabetic renal disease in diabetic patients: How to identify? When to biopsy?

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