POS-366 WHAT DOES A DIABETIC KIDNEY HIDE?

Abstract

Renal biopsy indications in diabetic patients are limited. We usually tend to biopsy when the diagnosis is doubted or when another diagnosis is suspected. Between 2007 and 2018, 548 patients were diagnosed with diabetic nephropathy (DN) , based on clinical and biological data. However, some patients needed a biopsy. Amongst 548 patients, only 29 have had renal biopsy. The leading symptom motivating the biopsy were hematuria ( 14 cases), then rapidly progressive renal failure (7 cases), renal failure without any proteinuria (3 cases), the absence of diabetic degenerative features (3 cases) and intense nephrotic syndrome (2 cases). All these patients had histological features of diabetic nephropathy. Nevertheless, eighteen (62%) had also non-diabetic renal disease( NDRD) which were acute glomerulonephritis (10 cases) , immunoglobulin A nephropathy (2 cases) , AL amyloidosis (2 cases) , chronic interstitial nephropathy ( 2 cases), acute interstitial nephritis (1 case) and 1 case of membranoproliferative glomerulonephritis. Distinguishing DN from NDRD on clinical facts is not obvious. However their association is not rare. Renal biopsy indications may be enlarged, new DN features may be found, and a better treatment strategy may be launched.