Title: A Study of Prevalence of Non Diabetic Renal Disease in Patients with Diabetic Nephropathy

Authors: Bhavya Dasara, Manjusha Yadla, Ramesh Chada, Sravan Kumar

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i11.32

Abstract

Introduction

Diabetic nephropathy is one of the leading cause of ESRD .It is also one of the most significant long term complications in terms of morbidity and mortality in patients with diabetes. Furthermore, prognosis in such patients is very poor compared with patients with ESRD due to other renal diseases. Diabetic nephropathy (DN) is suspected based on the presence of proteinuria, decline in GFR and elevation of blood pressure. Renal biopsy is not routinely performed in diabetic nephropathy patients. Recently, attention has been drawn to atypical presentation of diabetic and non diabetic glomerular diseases. Renal biopsy in proteinuric patients with diabetes mellitus is to confirm/exclude non-diabetic renal disease (NDRD). There are no standardized criteria for renal biopsy in DN, therefore doing a renal biopsy for patients with DN is the based on decision of the the treating nephrologist.

References

  1. Kramer CK, Leitao CB, Pinto LC, Silveiro SP, Gross JL, Canani LH: Clinical and laboratory profile of patients with type 2 diabetes with low glomerular filtration rate and normoalbuminuria. Diabetes Care 2007, 30:1998-2000.
  2. Fioretto P, Steffes MW, Sutherland DE, Goetz FC, Mauer M: Reversal of lesions of diabetic nephropathy after pancreas transplantation. N Engl J Med 1998, 339:69-75.
  3. Zukowska-Szczechowska E, Tomaszewski M. Renal affection in patients with diabetes mellitus is not always caused by diabetic nephropathy. Annales Academiae medicae Bialostocensis 2004;49:185-189
  4. Parving HH, Gall MA, Skott P, Jorgensen HE, et al. Prevalence and causes of albuminuria in non-insulin-dependent diabetic patients. Kidney Int 1992;41:758–62.
  5. J Prakash, M Lodha, SK Singh, et al.Diabetic Retinopathy is A Poor Predictor of Type of Nephropathy in Proteinuric Type 2 Diabetic Patients. JAPI JUNE 2007; 55 :412-416
  6. Jai prakash Non-Diabetic Renal Disease (NDRD) in Patients with Type 2 Diabetes Mellitus (Type 2 DM). JAPI 2013;  61:194-199
  7. Koji Harada etal.. Significance of renal biopsy in patients with presumed diabetic nephropathy. Journal of Diabetes Investigation 2013; 4 (1), p88-93.
  8. Amal Abdel Ghani etal.. Renal biopsy in patients with type 2 diabetes mellitus: indic ations and nature of lesions. Ann Saudi Med 2009;29(6):450-453.
  9. Michael Mauer, Michael W. Steffes etal.. Structural-Functional Relationships in Diabetic Nephropathy. J. Clin. Invest. 1984; 74: 1143-1155.
  10. Gambara V, Mecca G, Remuzzi G, Bertani T. Heterogeneous nature of renal lesions in type II diabetes. J Am Soc Nephrol 1993;3: 1458-1466.
  11. Jianhui Zhou etal..A differential diagnostic model of diabetic nephropathy and non-diabetic renal diseases. Nephrol Dial Transplant 2008; 23: 1940–1945.
  12. Das, Dakshinamurthy, etal..Non diabetic renal disease in type 2 diabetic patients: Single centre experience. Indian Journal of nephrology 2012;22(5): 358-362
  13. Schwartz MM etal. Renal pathology patterns in type II diabetes mellitus: relationship with retinopathy. Nephrol Dial Trasnsplant 1998;13:2547-2552.
  14. Serra A, Romero R, Bayes B et al. Is there a need for changes in renal biopsy criteria in proteinuria in Type 2 diabetes? Diabetes Research and Clinical Practice 2002;58:149-53.
  15. Prakash J etal.. Non-Diabetic Renal Disease in Patients with Type 2 Diabetes Mellitus J Assoc Physicians India.2001;49:415-20.
  16. Chavers, S. Michaelmauer etal. Relationship between retinal and Glomerular lesions in IDDM patients. DIABETES 1994;43:p 441-446.
  17. Sonia yaqub etal..Non-Diabetic renal disease in in patients with type 2 diabetes mellitus. Saudi J Kidney Dis Tanspl 2012;23(5): 1000-1007.
  18. . Kathryn Elizabeth White and Rudolf William Bilous etal.. Type 2 Diabetic Patients with Nephropathy Show Structural– Functional Relationships that Are Similar to    Type 1 Disease. J Am Soc Nephrol 2000;11: 1667–1673.
  19. Ruth Osterby, Hans-Henrikparving, Glomerular Structure and Function in Diabetic Nephropathy Early to Advanced Stages. DIABETES, 1990; 39:1057-1063

Corresponding Author

Bhavya Dasara

Department of Nephrology, Gandhi Hospital, Hyderabad

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.