#6834 PREVALENCE, ETIOLOGY AND CLINICAL CHARACTERISTICS OF BIOPSY PROVEN NON-DIABETIC RENAL DISEASE: 10 YEARS OF BIOPSES IN DIABETIC PATIENTS

Abstract

Abstract Background and Aims Diabetic nephropathy (DN) is the major cause of kidney disease in diabetic patients. However, a significant proportion of diabetic patients may actually have nondiabetic renal disease (NDRD). Therefore, it is important to identify patients who can benefit from a renal biopsy in order to establish the correct diagnosis. Our study aims to determine the prevalence and etiology of biopsy proven NDRD and to explore the clinical differences encountered in the diabetic patient with NDRD. Method Retrospective study of the medical records of all diabetic patients who underwent a renal biopsy due to suspicion of NDRD from January 2012 to December 2022 at Nephrology department Collected data comprised demographic information, indication and result of renal biopsy, lab results (serum creatinine, Hb1Ac, proteinuria, albuminemia, hematuria, presence of active urinary sediment and presence of auto antibodies) and disease's characteristics (duration of diabetes, presence of diabetic retinopathy). Categorical variables are presented as frequencies and percentages, continuous variables as means and standard deviations, or medians and interquartile ranges (IQR) for variables with skewed distributions. A p-value<0.05 was considered statistically significant. Statistical analysis was performed using SPSS version 28.1 for Mac OS X. Results 57 patients, 33.3% (n=19) were females, the medium age was 64.9 $\langle {{\rm{italic}}} \rangle \pm \langle {/{\rm{italic}}} \rangle $ 12.1. The most frequent indication for renal biopsy was acute kidney injury (26.3%), followed by rapidly progressive renal failure and nephrotic syndrome (22.8%). In our population, 22.9% had DN and 77.4% had NDRD. Pauciimune Glomerulonephritis (14%) and Membranous Nephropathy (10.5%) were the most common causes of NDRD. A chi-square test was performed to examine the relation between the two groups (ND vs NDRD) and the presence of diabetic retinopathy. There was a statistically significant association between the two variables ($\langle {{\rm{italic}}} \rangle {{\rm{X}}}^2\langle {/{\rm{italic}}} \rangle $= 11.778, p<0.01). Mann-Whitney test was performed to compare the median of duration the diabetes and Hb1Ac in two groups. That showed a statistically significant difference (U = 357, P = .018 and U=335.5 P = .013 respectively). Conclusion Since renal biopsy is critical to establish the correct diagnosis and provide an appropriate treatment, it should be performed in patients with high suspicion of NRDN, especially in patients with a recent diagnosis of diabetes, good metabolic control and the absence of diabetic retinopathy.