Renal pathological implications in type 2 diabetes mellitus patients with renal involvement

Li, Li; Zhang, Xiuhui; Li, Zhicheng; Zhang, Rui; Guo, Renhua; Yin, Qudong; Yang, Lichuan; Yue, Rongzheng; Su, Baihai; Huang, Songmin; Xu, Hong‐Xi; He, Cijiang; Liu, Fang

doi:10.1016/j.jdiacomp.2016.10.024

Cited by 71 publications

(65 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Interestingly, the outcomes of DKD superimposed NDRD from our center revealed that the prognosis of mixed types was better than that of NDRD (100% and 0%, respectively). [4] There was a disparity in the prognosis of DKD superimposed NDRD between our results and other similar investigations, which should be attributed to the proportion and sample size and may not represent the real prognosis of those patients. However, the ongoing study of the incidence, development, and prognosis of DKD launched by the First Hospital Affiliated Peking University, which covered more than 10,000 diabetic patients, may reveal a reliable consequence.…”

contrasting

confidence: 80%

Pathology and Prognosis of Type 2 Diabetes Mellitus with Renal Involvement

Cheng

2017

Chinese Medical Journal

View full text Add to dashboard Cite

contrasting

confidence: 80%

Pathology and Prognosis of Type 2 Diabetes Mellitus with Renal Involvement

Cheng

2017

Chinese Medical Journal

View full text Add to dashboard Cite

“…In patients with T2DM, NDKD prevalence is reported in different rates, when kidney biopsy indications, geographical area and/or ethnicity are considered [3-18]. Despite advances in therapeutics, DKD is remain one of the major diabetic complications [21].…”

Section: Discussionmentioning

confidence: 99%

“…Isolated DKD patients tend to have a worse prognosis compared to NDKD patients [8, 9 15, 18]. In a studyby Oh et al, during the monitoring period, ESKD rate was found to be 44% (22/50) in the DKD patient group, 18.2% (2/11) in the DKD+NDKD patient group and 12.3% (8/65) in the NDKD patient group.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Non-Diabetic Kidney Disease in Type 2 Diabetic Patients: Prevalence, Clinical Predictors and Outcomes

Erdogmus

Kiremitci

Celebi

et al. 2017

Kidney Blood Press Res

View full text Add to dashboard Cite

Background/Aims: Diabetic kidney disease (DKD) is one of the most frequent microvascular complications of diabetes and is the leading cause of end-stage kidney disease worldwide. In patients with diabetes, non-diabetic kidney disease (NDKD) can also occur. NDKD can be either alone or superimposed with the DKD. In this study, we aimed to investigate the utility of kidney biopsy in patients with type 2 diabetes mellitus (T2DM) and the predictability of diagnosing DKD versus NDKD from clinical and laboratory data. We also evaluated the prevalence and etiology of NDKD in patients with T2DM. Methods: We retrospectively reviewed type 2 diabetic patients who had kidney biopsy in the last 10 years for diagnosing possible NDKD in our center. In all patients kidney biopsies were performed because of atypical clinical features and biopsy samples were examined by light and immunofluorescence microscopy. Clinical parameters, laboratory workup and office blood pressures were recorded for each patient at the time of biopsy. Results: Eight patients were excluded due to missing data. A total of 48 patients (female/male: 26/22 and mean age: 59±8 years) were included in the study. According to the biopsy findings, 24 (50%) patients had NDKD alone, 20 (41.7%) had DKD alone and 4 (8.3%) had coexisting DKD and NDKD. The most common NDKD diagnoses were membranous nephropathy (29.2%), tubulointerstitial nephritis (20.8%) and IgA nephropathy (12.5%). There were no significant differences in three groups with respect to the duration of diabetes, proteinuria, hematuria and glycated hemoglobin A1c levels. Diabetic retinopathy (DR) was the most significant finding, which was associated with DKD. Positive and negative predictive values of DR for DKD were 88 and 81%, respectively. Conclusion: This study demonstrated a high prevalence of NDKD in patients with T2DM. The absence of DR strongly predicted NDKD. Clinical decision alone can lead to wrong diagnosis and delay in appropriate therapy. Clinicians should consider the kidney biopsy more liberally when there is uncertainty on the exact etiology of the kidney disease. However, prospective multicenter studies are needed to clarify the prognosis and outcomes of patients with diabetics.

show abstract

“…Se debe considerar siempre la posibilidad de la existencia de entidades diferentes a la ND en pacientes diabéticos no proteinúricos, independientemente de su edad, con elevación de azoados como causa de alteración de la función renal. La realización de un abordaje diagnóstico, de menor a mayor complejidad, y no retrasar la realización de biopsia renal percutánea permitirán identificar tempranamente los pacientes cuyo pronóstico será impactado y, por ende, alternativas terapéuticas diferentes 37 .…”

Section: Discussionunclassified

Características clínicas de una población de diabéticos tipo 2 con alteración en la función renal no macroalbuminúricos

Gómez

Valencia

Arango

2017

Rev. Colomb. Nefrol.

View full text Add to dashboard Cite

OriginalCaracterísticas clínicas de una población de diabéticos tipo 2 con alteración en la función renal no macroalbuminúricos ResumenAntecedentes: aunque la principal causa de deterioro en la función renal en pacientes diabéticos es la nefropatía diabética (ND), existen otras causas que siempre se deben investigar, especialmente cuando en ellos no se detecta macroalbuminuria. Objetivo: caracterización de variables demográficas, clínicas y etiológicas encontradas en una población de diabéticos tipo 2 de más de 10 años de evolución, no macroalbuminúricos, con elevación de azoados. Métodos: se identificaron 67 pacientes, en los cuales se practicaron diversos estudios imagenológicos para lograr un diagnostico etiológico. Si los estudios no fueron concluyentes, se procedió a practicar biopsia renal percutánea Resultados: la media de edad fue de 73,4 años (DE: 9,3). Media de creatinina 1,8 mg/dl, 50,75 % de los pacientes presentaron albuminuria normal (A1) y 49,3 % albuminuria moderadamente incrementada (A2). En 28 pacientes se obtuvo diagnósticos por imágenes, siendo la nefropatía hipertensiva el principal hallazgo. Se practicó biopsia renal al 58,20 % de la población (39 pacientes) y, en ellos, los diagnósticos fueron: ND aislada en el 28 % de los casos (11 pacientes), nefroesclerosis hipertensiva 28 % (11 pacientes), nefropatía mixta (diabética e hipertensiva) 18 % (7 pacientes), nefropatía por IgA 5 % (2 pacientes). Conclusiones: la nefropatía hipertensiva es la principal causa de elevación de azoados en diabéticos tipo 2 no macroalbuminúricos. La ND aislada sólo explica el 16,42 % (11 pacientes) de las causas de esta población.Palabras clave: nefropatías, diabetes mellitus, albuminuria, biopsia con aguja.doi: http://dx.doi.org/10.22265/acnef.4.2.271Abstract Background: The main cause of impaired renal function in diabetic patients is diabetic nephropathy (ND), but there are other causes that should always be investigated especially when they do not detect macroalbuminuria. Aims: Characterization of demographic, clinical and etiological variables found in a population of type 2 diabetics over 10 years of non-macroalbuminuric evolution with nitrogen products elevation. Methods: We identified 67 patients, in whom several imaging studies were performed to obtain an etiological diagnosis. If the studies were inconclusive, percutaneous renal biopsy was performed. Results: The mean age was 73.4 years (SD: 9.3). Mean creatinine 1.8 mg / dl, 50.75% of the patients had normal albuminuria (A1) and 49.3% moderately increased albuminuria (A2). In 28 patients, imaging diagnoses were obtained, with hypertensive nephropathy being the main finding. A total of 58.20% (39 patients) of the population were submitted to renal biopsy. ND was detected in the 28% of cases (11 patients), hypertensive nephrosclerosis 28% (11 patients), mixed nephropathy (diabetic and hypertensive) 18% (7 patients), 5% IgA nephropathy (2 patients).Conclusions: Hypertensive nephropathy is the main cause of elevated nitrogen products in non-macroalbuminuri...

show abstract

Renal pathological implications in type 2 diabetes mellitus patients with renal involvement

Cited by 71 publications

References 36 publications

Pathology and Prognosis of Type 2 Diabetes Mellitus with Renal Involvement

Pathology and Prognosis of Type 2 Diabetes Mellitus with Renal Involvement

Non-Diabetic Kidney Disease in Type 2 Diabetic Patients: Prevalence, Clinical Predictors and Outcomes

Características clínicas de una población de diabéticos tipo 2 con alteración en la función renal no macroalbuminúricos

Contact Info

Product

Resources

About