Jian-Zhen Fan1, Rong Wang2. 1. Department of General Medicine, Shandong University Qilu Hospital, Jinan, China. 2. Department of Nephrology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China.
Abstract
BACKGROUND: Non-diabetic renal disease (NDRD) has been widely known in diabetic patients. The clinical differentiation between diabetic nephropathy (DN) and NDRD is still not so clear and effective. AIM: To analyse the pathological characteristics and distribution of renal injury in selected type 2 diabetic patients. Comparison between DN and NDRD in clinical characteristics, to find important predictors for NDRD. METHODS: To conduct retrospective analysis of clinical, laboratory and pathohistological data of type 2 diabetic patients in whom renal biopsies were performed from March 2010 to September 2014 in Shandong Provincial Hospital affiliated to Shandong University (n = 88). RESULTS: According to the findings of renal biopsy, the incidences of DN, NDRD and DN complicated with NDRD were 20.46, 72.73 and 6.82% respectively. The most common NDRD found were: membranous nephropathy, followed by IgA nephropathy and focal segmental glomerulosclerosis. In multivariate logistic-analysis, fasting blood glucose (odds ratio (OR) 0.714; 95% confidence interval (CI) = 0.543-0.939; P = 0.016) and absence of diabetic retinopathy (OR 18.602; 95% CI = 2.176-159.018; P = 0.003) were independent predictors of NDRD. CONCLUSIONS: This study confirmed a considerably high prevalence of NDRD in type 2 diabetic patients with renal injury. As some cases of NDRD are readily treatable or remittable, we should consider renal biopsy in selected diabetic patients with renal involvement, especially in those with effective blood glucose control and the absence of diabetic retinopathy.
BACKGROUND:Non-diabetic renal disease (NDRD) has been widely known in diabeticpatients. The clinical differentiation between diabetic nephropathy (DN) and NDRD is still not so clear and effective. AIM: To analyse the pathological characteristics and distribution of renal injury in selected type 2 diabeticpatients. Comparison between DN and NDRD in clinical characteristics, to find important predictors for NDRD. METHODS: To conduct retrospective analysis of clinical, laboratory and pathohistological data of type 2 diabeticpatients in whom renal biopsies were performed from March 2010 to September 2014 in Shandong Provincial Hospital affiliated to Shandong University (n = 88). RESULTS: According to the findings of renal biopsy, the incidences of DN, NDRD and DN complicated with NDRD were 20.46, 72.73 and 6.82% respectively. The most common NDRD found were: membranous nephropathy, followed by IgA nephropathy and focal segmental glomerulosclerosis. In multivariate logistic-analysis, fasting blood glucose (odds ratio (OR) 0.714; 95% confidence interval (CI) = 0.543-0.939; P = 0.016) and absence of diabetic retinopathy (OR 18.602; 95% CI = 2.176-159.018; P = 0.003) were independent predictors of NDRD. CONCLUSIONS: This study confirmed a considerably high prevalence of NDRD in type 2 diabeticpatients with renal injury. As some cases of NDRD are readily treatable or remittable, we should consider renal biopsy in selected diabeticpatients with renal involvement, especially in those with effective blood glucose control and the absence of diabetic retinopathy.