Primary glomerulonephritis in diabetic patients.
Journal
International journal of clinical practice
ISSN: 1742-1241
Titre abrégé: Int J Clin Pract
Pays: India
ID NLM: 9712381
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
received:
03
07
2020
accepted:
11
09
2020
pubmed:
22
9
2020
medline:
12
5
2021
entrez:
21
9
2020
Statut:
ppublish
Résumé
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. 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. 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. 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.
Sections du résumé
BACKGROUND
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
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
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
CONCLUSIONS
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.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13713Informations de copyright
© 2020 John Wiley & Sons Ltd.
Références
Tervaert TWC, Mooyaart AL, Amann K, et al. Pathologic classification of diabetic nephropathy. J Am Soc Nephrol. 2010;21:556-563.
Adler AI, Stevens RJ, Manley SE, et al. Development and progression of nephropathy in type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS 64). Kidney Int. 2003;63:225-232.
Fiorentino M, Bolignano D, Tesar V, et al. Renal biopsy in patients with diabetes: a pooled meta-analysis of 48 studies. Nephrol Dial Transplant. 2017;32:97-110.
Sharma SG, Bomback AS, Radhakrishnan J, et al. The modern spectrum of renal biopsy findings in patients with diabetes. Clin J Am Soc Nephrol. 2013;8:1718-1724.
Soleymanian T, Hamid G, Arefi M, et al. Non-diabetic renal disease with or without diabetic nephropathy in type 2 diabetes: clinical predictors and outcome. Ren Fail. 2015;37:572-575.
Gonzalez Suarez ML, Thomas DB, Barisoni L, Fornoni A. Diabetic nephropathy: Is it time yet for routine kidney biopsy? World J Diabetes. 2013;4:245-255.
Zhuo L, Ren W, Li W, Zou G, Lu J. Evaluation of renal biopsies in type 2 diabetic patients with kidney disease: a clinicopathological study of 216 cases. Int Urol Nephrol. 2013;45:173-179.
Levey AS, Stevens LA, Schmid CH, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009;150:604-612.
American Diabetes Association. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes-2018. Diabetes Care. 2018;41:S13-S27.
Flack JM, Calhoun D, Schiffrin EL. The new ACC/AHA hypertension guidelines for the prevention, detection, evaluation, and management of high blood pressure in adults. Am J Hypertens. 2018;31:133-135.
KDIGO Clinical Practice Guideline for Glomerulonephritis. 2012.
Bi H, Chen N, Ling G, Yuan S, Huang G, Liu R. Nondiabetic renal disease in type 2 diabetic patients: a review of our experience in 220 cases. Ren Fail. 2011;33:26-30.
Suzuki D, Takano H, Toyoda M, et al. Evaluation of renal biopsy samples of patients with diabetic nephropathy. Intern Med. 2001;40:1077-1084.
Chang TI, Park JT, Kim J-K, et al. Renal outcomes in patients with type 2 diabetes with or without coexisting non-diabetic renal disease. Diabetes Res Clin Pract. 2011;92:198-204.
Kharrat M, Kammoun K, Charfeddine K, et al. Renal biopsy findings in diabetes mellitus. Tunis Med. 2007;85:216-219.
Mazzucco G, Bertani T, Fortunato M, et al. Different patterns of renal damage in type 2 diabetes mellitus: a multicentric study on 393 biopsies. Am J Kidney Dis. 2002;39:713-720.
Mou S, Wang Q, Liu J, et al. Prevalence of non-diabetic renal disease in patients with type 2 diabetes. Diabetes Res Clin Pract. 2010;87:354-359.
Pham TT, Sim JJ, Kujubu DA, Liu IL, Kumar VA. Prevalence of nondiabetic renal disease in diabetic patients. Am J Nephrol. 2007;27:322-328.
Dong Z, Wang Y, Qiu Q, et al. Clinical predictors differentiating non-diabetic renal diseases from diabetic nephropathy in a large population of type 2 diabetes patients. Diabetes Res Clin Pract. 2016;121:112-118.
Wong TYH, Choi PCL, Szeto CC, et al. Renal outcome in type 2 diabetic patients with or without coexisting nondiabetic nephropathies. Diabetes Care. 2002;25:900-905.
Soni SS, Gowrishankar S, Kishan AG, Raman A. Non diabetic renal disease in type 2 diabetes mellitus. Nephrology. 2006;11:533-537.
Tone A, Shikata K, Matsuda M, et al. Clinical features of non-diabetic renal diseases in patients with type 2 diabetes. Diabetes Res Clin Pract. 2005;69:237-242.
Lin YL, Peng SJ, Ferng SH, Tzen CY, Yang CS. Clinical indicators which necessitate renal biopsy in type 2 diabetes mellitus patients with renal disease. Int J Clin Pract. 2009;63:1167-1176.
Prakash J, Gupta T, Bhushan P, et al. Non-diabetic renal disease in type 2 diabetes mellitus: study of renal-Retinal relationship. Indian J Nephrol. 2015;25:222-228.
Kdoqi KDOQI. Clinical practice guidelines and clinical practice recommendations for diabetes and chronic kidney disease. Am J Kidney Dis. 2007;49:S12-154.
American Diabetes Association. Nephropathy in diabetes (Position Statement). Diabetes Care. 2004;27:S79-S83.
Chong Y-B, Keng T-C, Tan L-P, et al. Clinical predictors of non-diabetic renal disease and role of renal biopsy in diabetic patients with renal involvement: a single centre review. Ren Fail. 2012;34:323-328.
Hsieh JT, Chang FP, Yang AH, Tarng DC, Yang CY. Timing of kidney biopsy in type 2 diabetic patients: a stepwise approach. BMC Nephrol. 2020;21:131.
Liang S, Zhang X-G, Cai G-Y, et al. Identifying parameters to distinguish non-diabetic renal diseases from diabetic nephropathy in patients with type 2 diabetes mellitus: a meta-analysis. PLoS One. 2013;8:e64184.
Li LI, Zhang X, Li Z, et al. Renal pathological implications in type 2 diabetes mellitus patients with renal involvement. J Diabetes Complications. 2017;31:114-121.
Yenigun EC, Dede F, Ozturk R, et al. Non-diabetic renal disease in diabetes mellitus: clinical features and renal biopsy findings. Hippokratia. 2015;19:148-152.
Erdogmus S, Kiremitci S, Celebi Z, et al. Non-diabetic kidney disease in type 2 diabetic patients: prevalence, clinical predictors and outcomes. Kidney Blood Press Res. 2017;42:886-893.
Zhuo L, Zou G, Li W, Lu J, Ren W. Prevalence of diabetic nephropathy complicating non-diabetic renal disease among Chinese patients with type 2 diabetes mellitus. Eur J Med Res. 2013;18:4.
Liu S, Guo Q, Han H, et al. Clinicopathological characteristics of non-diabetic renal disease in patients with type 2 diabetes mellitus in a northeastern Chinese medical center: a retrospective analysis of 273 cases. Int Urol Nephrol. 2016;48:1691-1698.
Kritmetapak K, Anutrakulchai S, Pongchaiyakul C, Puapairoj A. Clinical and pathological characteristics of non-diabetic renal disease in type 2 diabetes patients. Clin Kidney J. 2018;11:342-347.