Prevalence and Clinicopathological Characteristics of NDRD in Type 2 DM Patients

Abstract

The prevalence of non-diabetic renal disease (NDRD) in type 2 diabetes mellitus (DM) varies depending on selection criteria and populations studied. Renal biopsies are not routinely performed in diabetic patients, but are indicated when NDRD is suspected. This study evaluated kidney biopsy histopathology and its correlation with clinical and biochemical parameters. Patients with type 2 DM who underwent renal biopsy for suspected NDRD from January 2015 to May 2023 were selected. Data analysis included clinical, laboratory, and histopathology findings. Patients were grouped as follows: Group I (pure diabetic nephropathy [DN]), Group II (NDRD with underlying DN), and Group III (pure NDRD). 41 biopsies were performed on type 2 DM patients. Mean age: 48.07±11.9 years, mean diabetes duration: 8.23±7.4 years, mean proteinuria: 11.37±8.0 mg/mmol, and mean creatinine: 2.19±2.05 mg/dl. 46.3% were hypertensives, 46.34% had diabetic retinopathy and 34.14% had hematuria. Among the studied group, 12 patients (29.26%) had pure DN, 10 patients (24.39%) had NDRD with underlying DN, and 19 patients (46.34%) had pure NDRD. The most common NDRD findings were membranous nephropathy 5 cases (26.31%) and focal segmental glomerulosclerosis 4 cases (21.05%). This study found a 46.34% incidence of NDRD in diabetic patients. NDRD should be suspected in atypical diabetic presentations, as early diagnosis and treatment may slow kidney disease progression.