Timing of kidney biopsy in type 2 diabetic patients: a stepwise approach

Hsieh, Jyh Tong; Chang, Fu Pang; Yang, An Hang; Tarng, Der Cherng; Yang, Chih Yu

doi:10.1186/s12882-020-01794-w

Cited by 17 publications

(25 citation statements)

References 46 publications

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“…In our study, as previously reported studies, initial proteinuria 28,30 serum albumin 19,31,32 serum glucose 33 , HbA1C 28,32,34 were not different in DN and NDKD patients. Similar to Liu et al 34 , our DN patients had lower serum hemoglobin levels.…”

Section: Discussionsupporting

confidence: 88%

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Primary Glomerulonephritis in Diabetic Patients

Kaya

Kuzu

Tanburoglu

et al. 2020

Preprint

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BACKGROUND Primary glomerulonephritis (PGN) has a significant part in non-diabetic kidney disease (NDKD) in diabetes mellitus (DM) patients. In our study, we compared the clinical, demographic, and laboratory features of patients with biopsyproven diabetic nephropathy (DN) and PGN with type 2 DM METHODS In our retrospective study, type 2 DM patients who underwent kidney biopsy between 2011-2019 were included. Demographic, clinical, and laboratory characteristics of DN and PGN patients were compared. RESULTS Seventy patients with a mean age of 55.7 ± 9.4 and 43 (61.4%) males were included. 38 (54.3%) of the patients had DN, and 32 (45.7%) had PGN. In the PGN, membranous GN (20, 62.5%) was most common. In DN patients, diabetes duration was longer; complications such as retinopathy, neuropathy, hypertension, coronary artery disease, heart failure were more frequent. At the time of renal biopsy, blood sugar, HbA1C, blood pressure, serum albumin, and proteinuria values were similar in 2 groups. The pathological damage findings of kidney biopsy in DN patients were more severe. In the first year after kidney biopsy decrease in eGFR was higher in DN patients, whereas eGFR did not change in PGN patients. CONCLUSION In a diabetic patient, fasting blood sugar, hbA1C, serum albumin, and proteinuria did not differ in the differential diagnosis of DN and PGN, whereas complications of DM (retinopathy, neuropathy, hypertension, coronary artery disease) were more characteristic in differentiation. Detection of PGN in a diabetic patient is crucial for the success of the treatment, according to DN. PRIMARY GLOMERULONEPHRITIS IN DIABETIC PATIENTS Background Primary glomerulonephritis (PGN) has a significant part in non-diabetic kidney disease (NDKD) in diabetes mellitus (DM) patients. In our study, we compared the clinical, demographic, and laboratory features of patients with biopsy-proven diabetic nephropathy (DN) and PGN with type 2 DM

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Section: Discussionsupporting

confidence: 88%

“…In type 2 DM, the onset of the disease is difficult to detect, so it is recommended to investigate for DN at the time of diagnosis 26 . As in our study, the incidence of NDKD increased in patients with short diabetes duration [27][28][29] .…”

Section: Discussionsupporting

confidence: 81%

Primary Glomerulonephritis in Diabetic Patients

Kaya

Kuzu

Tanburoglu

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…In our study, as previously reported studies, initial proteinuria 28,30 serum albumin 19,31,32 serum glucose, 33 HbA1C 28,32,34 were not different in DN and NDKD patients. Similar to Liu et al, 34 our DN patients had lower serum hemoglobin levels.…”

Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 78%

Primary glomerulonephritis in diabetic patients

et al. 2020

View full text Add to dashboard Cite

Background Primary glomerulonephritis (PGN) has a significant part in non‐diabetic kidney disease (NDKD) in diabetes mellitus (DM) patients. In our study, we compared the clinical, demographic and laboratory features of patients with biopsy‐proven diabetic nephropathy (DN) and PGN with type 2 DM. Methods In our retrospective study, type 2 DM patients who underwent kidney biopsy between 2011 and 2019 were included. Demographic, clinical and laboratory characteristics of DN and PGN patients were compared. Results Seventy patients with a mean age of 55.7 ± 9.4 and 43 (61.4%) males were included. About 38 (54.3%) of the patients had DN and 32 (45.7%) had PGN. In the PGN, membranous GN (20, 62.5%) was most common. In DN patients, diabetes duration was longer; complications such as retinopathy, neuropathy, hypertension, coronary artery disease, heart failure were more frequent. At the time of renal biopsy, blood sugar, HbA1C, blood pressure, serum albumin and proteinuria values were similar in two groups. The pathological damage findings of kidney biopsy in DN patients were more severe. In the first year after kidney biopsy decrease in eGFR was higher in DN patients, whereas eGFR did not change in PGN patients. Conclusion In a diabetic patient, fasting blood sugar, hbA1C, serum albumin and proteinuria did not differ in the differential diagnosis of DN and PGN, whereas complications of DM (retinopathy, neuropathy, hypertension, coronary artery disease) were more characteristic in differentiation. Detection of PGN in a diabetic patient is crucial for the success of the treatment, according to DN.

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“…Due to its indolent nature, chronic kidney disease diagnosed after DR is typically presumed to be DN [5]. However, diabetic patients with high amounts of proteinuria without DR are recommended for a kidney biopsy to rule out other glomerular diseases [13][14][15][16]. Because frequent complications from kidney biopsy often occur, many patients may refuse to receive one.…”

Section: Introductionmentioning

confidence: 99%

Manifestation of rs1888747 polymorphisms in the FRMD3 gene in diabetic kidney disease and diabetic retinopathy in type 2 diabetes patients

Kreepala

Panpruang

Yodprom

et al. 2021

Kidney Res Clin Pract

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Background: FRMD3 polymorphisms has suggested that they could be an alternative test to differentiate diabetic nephropathy (DN) from nondiabetic renal disease (NDRD) in type 2 diabetes mellitus (DM) patients. This study was performed to investigate the relationship between the FRMD3 gene and clinical characteristics of DN. Methods: Patients who already had renal pathologic results were tested for FRMD3 polymorphisms. The subjects were classified into three groups; DN with diabetic retinopathy (DR), DN without DR, and DM with NDRD. FRMD3 polymorphisms were analyzed in each group. Results: The prevalence of GG, CG, and CC was 44.4%, 42.2%, and 13.3% respectively. There was no significant difference in clinical parameters, which consisted of disease duration, proteinuria, and complications in DN with or without DR and DM with NDRD. The G allele was mainly found in DN with DR patients (50.8%) whereas the C allele was found in DM with NDRD patients (43.5%) (p = 0.02). There was a significant association between the CC genotype in NDRD when compared to GG (p = 0.001). In addition, the C allele was 2.10-fold more often associated with NDRD than the G allele (p = 0.03). The CC genotype was correlated with risk for NDRD than the GG and GC genotypes, with odds ratios of 6.89 and 4.91, respectively (p = 0.02). Conclusion: C allele presentation, especially homozygous CC, was associated with NDRD pathology in patients with overt proteinuria. Hence, kidney biopsy is suggested in those with the C allele or homozygous CC genotype, regardless of retinopathy manifestations.

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Timing of kidney biopsy in type 2 diabetic patients: a stepwise approach

Cited by 17 publications

References 46 publications

Primary Glomerulonephritis in Diabetic Patients

Primary Glomerulonephritis in Diabetic Patients

Primary glomerulonephritis in diabetic patients

Manifestation of rs1888747 polymorphisms in the FRMD3 gene in diabetic kidney disease and diabetic retinopathy in type 2 diabetes patients

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