Abstract
Background of the Study, Aims and Objectives: There are very few studies on histological patterns of diabetic nephropathy in our part of country. The aim of this study was to evaluate the renal involvement in patients with Type-2 diabetes mellitus (T2DM), assess the histopathological changes and establish a clinico-pathological correlation. Subjects, Method and Materials: Thirty two Type 2 DM patients with nephropathy, after screening consecutive hundred(100) Type 2 Diabetics admitted to the Medicine Department were evaluated for renal involvement by kidney biopsy and histopathological study. Statistical analysis was done by student’s t-test, chi-square and linear regression analysis. Results: Thirty two patients (32) with diabetic nephropathy (20 males and 12 females) formed the study group out of hundred (100) consecutive Type-2 diabetes mellitus patients (58 males and 42 females) admitted to Medicine Department of SCB Medical College Hospital, Cuttack. The frequency of occurrence of clinical diabetic nephropathy was 32%. Most of the patients were having duration of DM of 6-10 years (87.5%). Pedal edema was found in 96.87%, hypertension in 87.5% patients respectively. Regression analysis showed that durations of DM and HbA1c were the two significant risk factors (P Histopathologically, diffuse glomerulosclerosis was the most common form of renal abnormality found in 93.75% followed by nodular glomerulosclerosis in 62.50% with overlap in many patients, membranous nephropathy in 12.5% and focal necrotising glomerulonephritis in 6.25% respectively. There was no statistically significant clinicopathological correlation observed between clinical and biochemical parameters in patients harbouring the two predominant histological types of nephropathy i.e. diffuse and nodular glomerulosclerosis with respect to age, sex, duration of diabetes, body mass index, systolic blood pressure, HbA1c, 24 hour urinary protein, creatinine clearance, serum urea, serum creatinine or lipid profile. Conclusion: Durations of diabetes and HbA1c were found to be strongly associated with development of diabetic nephropathy. Diffuse glomerulosclerosis was the most common form of renal abnormality found in 93.75% followed by nodular glomerulosclerosis in 62.50% of patients.
Highlights
The global burden of DM is enormous with an estimated 366 million people living with DM worldwide (2011) [1]
We found the incidence of diabetic nephropathy to be 32% in hospitalised patients
Nephopathy occurs at a much earlier age in Type-2 diabetes mellitus (T2DM) patients in India and the duration of diabetes resulting in nephropathy is less as compared to the western population
Summary
The global burden of DM is enormous with an estimated 366 million people living with DM worldwide (2011) [1]. The aim of this study was to evaluate the renal involvement in patients with Type-2 diabetes mellitus (T2DM), assess the histopathological changes and establish a clinico-pathological correlation. Method and Materials: Thirty two Type 2 DM patients with nephropathy, after screening consecutive hundred(100) Type 2 Diabetics admitted to the Medicine Department were evaluated for renal involvement by kidney biopsy and histopathological study. There was no statistically significant clinicopathological correlation observed between clinical and biochemical parameters in patients harbouring the two predominant histological types of nephropathy i.e. diffuse and nodular glomerulosclerosis with respect to age, sex, duration of diabetes, body mass index, systolic blood pressure, HbA1c, 24 hour urinary protein, creatinine clearance, serum urea, serum
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