Renal Biopsy in Patients with Type 2 Diabetes Mellitus: Indications and Nature of the Lesions

Ghani, Amal Abdel; Waheeb, Salah AI; Sahow, Ali AI; Hussain, Naser

doi:10.5144/0256-4947.2009.450

Cited by 14 publications

(33 citation statements)

References 19 publications

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“…This finding is in agreement with results of other studies. 8,9,13,14 Overall, the common NDRD in both groups (II and III) were MN (34%), FGS (20.5%), AIN (20.5%), and IgA nephropathy (10%). These findings are in contrast to reports from Southeast Asia which IgA nephropathy (up to 65%) was the most common NDRD.…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7][8][9][10][11][12] The most common pathologies in NDRD group were MN (45%) and FGS (30%), respectively. In the DN + NDRD group, although AIN (60%) was the most common lesion, IgA nephropathy (20%) was the prevalent glomerulopathy.…”

Section: Discussionmentioning

confidence: 99%

“…4,5 The reported prevalence of NDRD ± DN in diabetes patients is in the range of 17-85% depends upon given institution's biopsy policy and geographic place. [5][6][7][8][9][10][11][12] The importance of NDRD diagnosis is appreciated by the reported better kidney survival following appropriate therapy. 10 The atypical clinical features of renal involvement, specially in short duration of diabetes which warrant renal biopsy, are determined due to the absence of diabetic retinopathy, rapidly decreasing renal function, briskly rising proteinuria or acute onset of nephrotic syndrome, and active urine sediment.…”

Section: Introductionmentioning

confidence: 99%

“…10 The atypical clinical features of renal involvement, specially in short duration of diabetes which warrant renal biopsy, are determined due to the absence of diabetic retinopathy, rapidly decreasing renal function, briskly rising proteinuria or acute onset of nephrotic syndrome, and active urine sediment. [5][6][7][8][9][10][11][12] The present prospective study was carried out to estimate the frequency of NDRD ± DN in type 2 diabetes patients presented with atypical features of diabetic renal involvement. We also investigated the clinical course, renal outcome, and clinical predictors of NDRD.…”

Section: Introductionmentioning

confidence: 99%

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Non-diabetic renal disease with or without diabetic nephropathy in type 2 diabetes: clinical predictors and outcome

et al. 2015

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Background: Renal involvement in type 2 diabetes is mostly due to diabetic nephropathy (DN), but a subset of diabetic patients could present with pure non-diabetic renal disease (NDRD) or NDRD superimposed on DN. We conducted a prospective cohort study to identify the underline renal pathology in type 2 diabetic patients with defined clinical criteria for renal biopsy.Methods: A total of 46 patients (27 female, mean age of 48.9 ± 11.9 years) with type 2 diabetes mellitus (DM) and atypical features of DN with unexpected proteinuria, hematuria, and/or renal impairment were enrolled in this study. Results: Of 46 patients with type 2 diabetes, 16 (34.8%) had DN, 20 (43.5%) had NDRD, and 10 (21.7%) had NDRD superimposed on DN. Membranous nephropathy (34%) was the most common NDRD. Patients with NDRD had a lower frequency of diabetic retinopathy (5%), shorter duration of diabetes, higher range of proteinuria, and better kidney survival. In multiple logistic regression analysis, only lack of diabetic retinopathy was independent predictor of NDRD. Positive and negative predictive value of diabetic retinopathy (DR) for diabetic nephropathy was 94 and 68%, respectively. Conclusion: Kidney biopsy is strongly recommended for patients with type 2 diabetes and atypical renal presentation for DN, particularly in the absence of DR. This approach could lead to diagnosis of NDRD with better renal survival.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Non-diabetic renal disease with or without diabetic nephropathy in type 2 diabetes: clinical predictors and outcome

et al. 2015

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“…Udio nedijabetesne bubrežne bolesti kod bolesnika sa dijabetesom u više objavljenih studija je različit [2][3][4][5][6][7][8][9] (Tabela 2).…”

Section: Diskusijaunclassified

Renal biopsy in diabetic patients (experience of Nephrology Department of Clinic for Internal Diseases UCC Banjaluka)

Grujičić¹,

Jovanović

Salapura³

et al. 2014

Biomedicinska istraž.

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Kratak sadržajUvod. Bolesnici sa dijabetes melitusom mogu osim dijabetesne nefropatije da imaju i nedijabetesnu bolest bubrega koja se najbolje dokazuje biopsijom bubrega. Cilj rada je da se biopsijom bubrega utvrdi učestalost i vrsta nedijabetesne bolesti bubrega kod bolesnika sa dijabetesom.Metode. U periodu od aprila 2007. do maja 2013. godine urađeno je devet biopsija (dva muškarca) bubrega kod bolesnika sa dijabetesom na Odjelu za nefrologiju Klinike za unutrašnje bolesti KC Banja Luka. Prosjek trajanja dijabetesa je bio 4,9 godina, retinopatiju je imao jedan, a hipertenziju sedam bolesnika. Biopsija je rađena biopsijskim pištoljem Fast Gun sa iglom promjera 16G, pod kontrolom ultrazvuka (Toshiba Famio 5 sa sondom vodilicom). Uzimana su dva uzorka tkiva: za optičku mikroskopiju i imunofluorescenciju.Rezultati. Indikacije za biopsiju su bile: nefrotski sindrom kod šest bolesnika, asimptomatske urinarne abnormalnosti (perzistentna proteinurija i/ ili mikrohematurija) kod dva, sistemski lupus eritematodes kod jednog. Kod šest pacijenata je postavljena patohistološka dijagnoza dijabetesne nefropatije, dva pacijenta su imala kombinovano dijabetesnu nefropatiju sa drugom bolešću bubrega (jedan sa hipertenzivnom nefroangiosklerozom, a drugi sa lupus nefritisom) i jedan pacijent primarni membranozni glomerulonefritis.Zaključak. Biopsija bubrega kod naših devet bolesnika sa dijabetesom je pokazala da su tri bolesnika (33,3%) imala nedijabetesnu bolest bubrega. Dva od tri bolesnika sa nedijabetesnom bolesti bubrega su imala glomerulsku, a jedan vaskularnu bolest bubrega (hipertenzivna nefroangioksleroza). Iako je uzorak bolesnika manji u poređenju sa studijama drugih autora, naša prva iskustva ukazuju da postoji značajan procenat bolesnika sa dijabetesom koji imaju nedijabetesnu bolest bubrega, što se sigurno može dokazati samo biosijom bubrega.

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

et al. 2015

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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.

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Renal Biopsy in Patients with Type 2 Diabetes Mellitus: Indications and Nature of the Lesions

Cited by 14 publications

References 19 publications

Non-diabetic renal disease with or without diabetic nephropathy in type 2 diabetes: clinical predictors and outcome

Non-diabetic renal disease with or without diabetic nephropathy in type 2 diabetes: clinical predictors and outcome

Renal biopsy in diabetic patients (experience of Nephrology Department of Clinic for Internal Diseases UCC Banjaluka)

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

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