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International Urology and Nephrology

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Open Access 06-03-2023 | Diabetic Retinopathy | Nephrology - Original Paper

Clinico-pathological features of diabetic and non-diabetic renal diseases in type 2 diabetic patients: a retrospective study from a 10-year experience in a single center

Authors: Yuemeng Sun, Yawei Ren, Ping Lan, Xiaoyang Yu, Jie Feng, Dapeng Hao, Liyi Xie

Published in: International Urology and Nephrology | Issue 9/2023

Abstract

Aim

To compare clinical and pathological characteristics as well as prognosis between diabetic nephropathy (DN) and non-diabetic renal disease (NDRD) so as to explore potential diagnostic criteria of DN and provide some guidance for the treatment of type 2 diabetes mellitus (T2DM) patients with kidney involvement.

Methods

T2DM patients with renal impairment who underwent kidney biopsy were included in this study, who were classified into 3 groups (DN, NDRD, DN with NDRD) based on their renal pathological diagnosis. Baseline clinical characteristics as well as follow-up data were collected and analyzed among 3 groups. Logistic regression was performed to determine the best predictors for DN diagnosis. Additional 34 MN patients without diabetes were enrolled by propensity score matching method to compare serum PLA2R antibody titer and kidney outcomes between diabetic MN patients and MN alone.

Results

Among 365 patients with type 2 diabetes who underwent kidney biopsy, 179 (49.0%) patients were diagnosed with NDRD alone and 37 (10.1%) patients with NDRD combined DN. Risk factors for DN development in T2DM patients were longer time since diabetes diagnosis, higher level of serum creatinine, absence of hematuria and presence of diabetic retinopathy by multivariate analysis. Lower rate of proteinuria remission and higher risk of renal progression were observed in DN group compared with NDRD group. Membranous nephropathy was the most common NDRD in diabetic patients. There was no difference in serum PLA2R antibody positiveness or titer between MN patients with or without T2DM. There was lower remission rate but similar renal progression in diabetic MN when age, gender, baseline eGFR, albuminuria and IFTA score were adjusted.

Conclusions

Non-diabetic renal disease is not uncommon in T2DM patients with renal impairment, which has better prognosis with proper treatment. Coexisting diabetic status does not exert negative impact on renal progression in MN patients, and immunosuppressive agents should be administered when necessary.

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Title: Clinico-pathological features of diabetic and non-diabetic renal diseases in type 2 diabetic patients: a retrospective study from a 10-year experience in a single center
Authors: Yuemeng Sun
Yawei Ren
Ping Lan
Xiaoyang Yu
Jie Feng
Dapeng Hao
Liyi Xie
Publication date: 06-03-2023
Publisher: Springer Netherlands
Keywords: Diabetic Retinopathy
Diabetic Retinopathy
Hematuria
Diabetic Nephropathy
Diabetes
Type 2 Diabetes
Published in: International Urology and Nephrology / Issue 9/2023
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI: https://doi.org/10.1007/s11255-023-03478-4

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Results

Conclusions

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