A history of any pretransplant malignancy was associated with increased risks of skin and solid malignancies after transplantation. The specific type of posttransplant malignancy risk differed according to the type of pretransplant malignancy.

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Background: When non-diabetic renal disease (NDRD) is suspected, kidney biopsy is used for definite diagnosis; however, this is not always easily available and may lead to complications. A clinical prediction score may help selecting appropriate patients for kidney biopsy.Methods: A retrospective cohort study was conducted in type 2 diabetes mellitus (T2DM) patients with atypical features of diabetic nephropathy (DN), who had kidney biopsy at Thammasat University Hospital from 2011-2019. We divided patients into NDRD alone, coexisting NDRD and DN, and DN alone, confirmed by pathological diagnosis. We developed a clinical prediction score by weighing coefficients of predictors in a multivariable logistic model. Internal validation was performed with bootstrapping.Results: We included 81 patients: 28 (34%) had NDRD alone, 15 (18%) had coexisting NDRD and DN, and 38 (41%) had DN alone. Primary membranous nephropathy, primary focal and segmental glomerulosclerosis (FSGS), and secondary FSGS were prevalent in any NDRD. Absence of diabetic retinopathy (DR) showed a significant association with any NDRD (OR 3.72; 95% CI, 1.28-10.8; p=0.02). The prediction score, AUC of 0.75 (95% CI, 0.63-0.86), had four predictors: duration of DM <10 years, eGFR >30 ml/min/1.73m2, HbA1c <8%, and absence of DR. Higher scores were associated with higher probability of NDRD.Conclusions: This clinical prediction score appears to be a useful tool to determine NDRD probability. T2DM patients with atypical presentation of DN with lower scores (0-2) may defer kidney biopsy.

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