Abstract
Aims
The indications for renal biopsy in type 2 diabetes mellitus (T2D) are not well established. We investigated the prevalence, spectrum, and predictors of biopsy-proven non-diabetic renal disease (NDRD) in T2D.
Methods
An observational, single-center, retrospective study of T2D adults who underwent renal biopsies (N = 51) over 10 years for nephrotic-range proteinuria, microscopic hematuria, or rapidly declining renal function.
Results
Thirty-five (68.6%) biopsies were diagnostic of NDRD, and 16 (31.4%) revealed isolated diabetic nephropathy. The most common NDRDs were interstitial nephritis (20%), progressive crescentic glomerulonephritis (14%), membranous nephropathy (11%), and focal segmental glomerulosclerosis (11%). The odds for NDRD declined by 97% in the presence of diabetic retinopathy (P < 0.001). The deterioration of HbA1c during the year before biopsy predicted NDRD even after adjusting for diabetic retinopathy (OR, 7.65; 95% CI, 1.36–123.04; P = 0.003). A model based on the interaction between the HbA1c values 12 months before biopsy and the absolute change in these values during the preceding year predicted NDRD with 73.7% sensitivity and 75% specificity (AUC, 0.77; 95% CI, 0.59–0.94).
Conclusions
This study demonstrated a considerably high prevalence of NDRD in T2D adults undergoing renal biopsy. The absence of diabetic retinopathy, lower HbA1c values 12 months before biopsy and greater deterioration in HbA1c prior to biopsy predicted NDRD in T2D. Further studies are needed to validate the findings.
| Original language | English |
|---|---|
| Journal | Journal of Diabetes and its Complications |
| Early online date | 13 Dec 2014 |
| DOIs | |
| Publication status | E-pub ahead of print - 13 Dec 2014 |
Keywords
- Glycated hemoglobin
- Renal biopsy
- Renal disease
- Type 2 diabetes mellitus
- Non-diabetic renal disease
Access to Document
- Pallayova_et_al_Predicting_non_diabetic_renal_disease_Journal_Diabetes_Complications_2014
NOTICE: this is the author’s version of a work that was accepted for publication. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published as Pallayova, M., Mohammed, A., Langman, G., Taheri, S. & Dasgupta, I., Predicting non-diabetic renal disease in type 2 diabetic adults: The value of glycated haemoglobin, Journal of Diabetes and Its Complications (2014), doi: 10.1016/j.jdiacomp.2014.12.005.