Primary glomerulonephritis in diabetic patients

Kaya, Bülent; Paydaş, Saime; Kuzu, Tolga; Tanburoglu, Derya Basak; Balal, Mustafa; Erdoğan, Kıvılcım Eren; Gönlüşen, Gülfiliz

doi:10.1111/ijcp.13713

Cited by 4 publications

(1 citation statement)

References 32 publications

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“…Common causes of nephrotic syndrome (NS) include membranous nephropathy (MN), diabetic nephropathy (DN), and focal segmental glomerulosclerosis. Approximately 1/3rd of the diabetics with proteinuria who have undergone renal biopsy are cases of nondiabetic renal disease [1] and MN is the most common pathologic type. About 30%-40% of diabetics can develop into DN.…”

Section: Introductionmentioning

confidence: 99%

Treatment with rituximab and hydroxychloroquine in a patient with membranous nephropathy and diabetic nephropathy: A case report

Ning¹,

Xu²,

Chen³

et al. 2023

Diabetic Nephropathy

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Nephrotic syndrome (NS), which includes primary and secondary types, is one of the causes of end-stage kidney disease. Common causes in adults include diabetic nephropathy (DN), membranous nephropathy (MN), and focal segmental glomerulosclerosis. About 30%–40% of diabetics can develop into DN. The incidence of primary nephrotic syndrome in diabetic patients was not significantly different from that in the general population. Herein we present a windfall from the treatment of rituximab combined with hydroxychloroquine in a patient with primary MN and DN. A 51-year-old Chinese man, diagnosed with type 2 diabetes mellitus (T2DM) 12 years ago, was admitted to the hospital due to edema of bilateral lower limbs and severe proteinuria. Serology showed the obvious elevation of the anti-phospholipase A2 receptor (anti-PLA2R) level and renal biopsy showed MN concomitant with DN. After low dosage of prednisone and standard dosage of rituximab, the patient’s proteinuria decreased; however, the effect was unsatisfactory and proteinuria was elevated again in 8 months. Thus, treatment with rituximab and hydroxychloroquine was initiated, which resulted in proteinuria diminishing significantly and albumin returning to normal level. Therefore, even complicated with DN, patients diagnosed with primary MN still have a promising remission after being treated with rituximab and hydroxychloroquine.

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Section: Introductionmentioning

confidence: 99%

Treatment with rituximab and hydroxychloroquine in a patient with membranous nephropathy and diabetic nephropathy: A case report

Ning¹,

Xu²,

Chen³

et al. 2023

Diabetic Nephropathy

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Kidney Biopsy Findings Among Patients With Diabetes in the Cleveland Clinic Kidney Biopsy Epidemiology Project

Kwon,

Sawaf,

Portalatin

et al. 2024

Kidney Medicine

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Serum anti-phospholipase A2 receptor antibody in pathological diagnosis of type 2 diabetes mellitus patients with proteinuria

Zhang,

Zhu,

et al. 2023

Sci Rep

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Patients with diabetes mellitus complicated with proteinuria can be diabetic nephropathy (DN), diabetic complicated with non-diabetic kidney disease (NDKD), or DN with NDKD. Among these membranous nephropathy accounted for a large proportion of DN with NDRD. At present, serum anti-phospholipase A2 receptor (PLA2R) antibody is widely used in the diagnosis and evaluation of therapy in idiopathic membranous nephropathy, our study aimed to investigate the diagnostic significance of anti-PLA2R antibody in type 2 diabetes mellitus (T2DM) patients with proteinuria, providing a method for patients with contraindications of kidney biopsy. Eighty-seven T2DM patients with proteinuria who went on kidney biopsy were divided into the DN group, idiopathic membranous nephropathy (IMN) group, and others group according to their pathological results. In our study, 52.87% and 28.74% of patients were found to have IMN and diabetic nephropathy respectively. The levels of anti-PLA2R antibody, total cholesterol, triglyceride, and estimated glomerular filtration rate (eGFR) were higher in the IMN group, while the prevalence of diabetic retinopathy (DR), systolic blood pressure (SBP) and HbA1c were higher in the DN group. For T2DM patients with proteinuria, anti-PLA2R antibody (AUC = 0.904, 95%CI 0.838–0.970) has a high diagnostic value for IMN. The duration of diabetes (OR = 0.798, P = 0.030), eGFR level (OR = 1.030, P = 0.024), and positive anti-PLA2R antibody (OR = 72.727, P < 0.001) favor the diagnosis of IMN, while DR (OR = 50.234, P < 0.001), SBP (OR = 1.041, P = 0.030), and negative anti-PLA2R antibody (OR = 0.008, P = 0.001) is beneficial to the diagnosis of DN. Our study found that NDKD is not uncommon in patients with T2DM and proteinuria, and IMN was the main pathological type. Positive anti-PLA2R antibody has a strong accuracy in the diagnosis of IMN in patients with T2DM and proteinuria.

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Primary glomerulonephritis in diabetic patients

Cited by 4 publications

References 32 publications

Treatment with rituximab and hydroxychloroquine in a patient with membranous nephropathy and diabetic nephropathy: A case report

Treatment with rituximab and hydroxychloroquine in a patient with membranous nephropathy and diabetic nephropathy: A case report

Kidney Biopsy Findings Among Patients With Diabetes in the Cleveland Clinic Kidney Biopsy Epidemiology Project

Serum anti-phospholipase A2 receptor antibody in pathological diagnosis of type 2 diabetes mellitus patients with proteinuria

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