Predictive factors for non-diabetic nephropathy in diabetic patients. The utility of renal biopsy
Background and objectives: Diabetic renal lesions can only be diagnosed by kidney biopsy. These biopsies have a high prevalence of non-diabetic lesions. The aims of the study were to determine the predictability of non-diabetic nephropathy (NDN) in diabetics and study differences in survival and ren...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2016-09-01
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| Series: | Nefrología (English Edition) |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2013251416301250 |
| _version_ | 1818994568156151808 |
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| author | Sheila Bermejo María José Soler Javier Gimeno Clara Barrios Eva Rodríguez Sergi Mojal Julio Pascual |
| author_facet | Sheila Bermejo María José Soler Javier Gimeno Clara Barrios Eva Rodríguez Sergi Mojal Julio Pascual |
| author_sort | Sheila Bermejo |
| collection | DOAJ |
| description | Background and objectives: Diabetic renal lesions can only be diagnosed by kidney biopsy. These biopsies have a high prevalence of non-diabetic lesions. The aims of the study were to determine the predictability of non-diabetic nephropathy (NDN) in diabetics and study differences in survival and renal prognosis. In addition, we evaluated histological lesions and the effect of proteinuria on survival and renal prognosis in patients with diabetic nephropathy (DN).
Material and methods: A descriptive, retrospective study of kidney biopsies of diabetics between 1990 and 2013 in our centre.
Results: 110 patients were included in the study: 87 men (79%), mean age 62 years (50–74), mean serum creatinine 2.6 mg/dl (0.9–4.3) and proteinuria 3.5 g/24 hours (0.5–6.5). 61.8% showed NDN, 34.5% showed DN and 3.6% showed DN + NDN. The most common NDN was IgA nephropathy (13.2%). In the multivariate analysis, creatinine (OR: 1.48, 1.011–2.172, p = 0.044), proteinuria/24 hours (OR: 0.813, 0.679–0.974, p = 0.025), duration of diabetes (OR: 0.992, 0.987–0.998, p = 0.004), age (OR: 1.068, 95% CI: 1.010–1.129, p = 0.022), and diabetic retinopathy (OR: 0.23, 0.066–0.808, p = 0.022) were independently associated with NDN. We did not find any differences in survival or renal prognosis. Concerning patients with DN, increased nodular mesangial expansion (p = 0.02) and worse renal prognosis (p = 0.004) were observed in nephrotic proteinuria as compared to non-nephrotic proteinuria. We did not find differences in patient survival.
Conclusions: The most common cause of NDN was IgA nephropathy. Higher creatinine levels, shorter duration of diabetes, absence of diabetic retinopathy, lower proteinuria, and older age were risk factors for NDN. Patients with DN and nephrotic-range proteinuria had worse renal prognosis. |
| first_indexed | 2024-12-20T21:00:01Z |
| format | Article |
| id | doaj.art-822fe313ae984fda8ca2456d5b7bd34d |
| institution | Directory Open Access Journal |
| issn | 2013-2514 |
| language | English |
| last_indexed | 2024-12-20T21:00:01Z |
| publishDate | 2016-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Nefrología (English Edition) |
| spelling | doaj.art-822fe313ae984fda8ca2456d5b7bd34d2022-12-21T19:26:43ZengElsevierNefrología (English Edition)2013-25142016-09-0136553554410.1016/j.nefroe.2016.11.013Predictive factors for non-diabetic nephropathy in diabetic patients. The utility of renal biopsySheila Bermejo0María José Soler1Javier Gimeno2Clara Barrios3Eva Rodríguez4Sergi Mojal5Julio Pascual6Servicio de Nefrología, Hospital del Mar, REDINREN RD12/0021/0024, Barcelona, SpainServicio de Nefrología, Hospital del Mar, REDINREN RD12/0021/0024, Barcelona, SpainServicio de Anatomía Patológica, Hospital del Mar, REDINREN RD12/0021/0024, Barcelona, SpainServicio de Nefrología, Hospital del Mar, REDINREN RD12/0021/0024, Barcelona, SpainServicio de Nefrología, Hospital del Mar, REDINREN RD12/0021/0024, Barcelona, SpainFundación IMIM, Hospital del Mar, REDINREN RD12/0021/0024, Barcelona, SpainServicio de Nefrología, Hospital del Mar, REDINREN RD12/0021/0024, Barcelona, SpainBackground and objectives: Diabetic renal lesions can only be diagnosed by kidney biopsy. These biopsies have a high prevalence of non-diabetic lesions. The aims of the study were to determine the predictability of non-diabetic nephropathy (NDN) in diabetics and study differences in survival and renal prognosis. In addition, we evaluated histological lesions and the effect of proteinuria on survival and renal prognosis in patients with diabetic nephropathy (DN). Material and methods: A descriptive, retrospective study of kidney biopsies of diabetics between 1990 and 2013 in our centre. Results: 110 patients were included in the study: 87 men (79%), mean age 62 years (50–74), mean serum creatinine 2.6 mg/dl (0.9–4.3) and proteinuria 3.5 g/24 hours (0.5–6.5). 61.8% showed NDN, 34.5% showed DN and 3.6% showed DN + NDN. The most common NDN was IgA nephropathy (13.2%). In the multivariate analysis, creatinine (OR: 1.48, 1.011–2.172, p = 0.044), proteinuria/24 hours (OR: 0.813, 0.679–0.974, p = 0.025), duration of diabetes (OR: 0.992, 0.987–0.998, p = 0.004), age (OR: 1.068, 95% CI: 1.010–1.129, p = 0.022), and diabetic retinopathy (OR: 0.23, 0.066–0.808, p = 0.022) were independently associated with NDN. We did not find any differences in survival or renal prognosis. Concerning patients with DN, increased nodular mesangial expansion (p = 0.02) and worse renal prognosis (p = 0.004) were observed in nephrotic proteinuria as compared to non-nephrotic proteinuria. We did not find differences in patient survival. Conclusions: The most common cause of NDN was IgA nephropathy. Higher creatinine levels, shorter duration of diabetes, absence of diabetic retinopathy, lower proteinuria, and older age were risk factors for NDN. Patients with DN and nephrotic-range proteinuria had worse renal prognosis.http://www.sciencedirect.com/science/article/pii/S2013251416301250Renal biopsyDiabetes mellitusNon-diabetic nephropathyDiabetic nephropathy |
| spellingShingle | Sheila Bermejo María José Soler Javier Gimeno Clara Barrios Eva Rodríguez Sergi Mojal Julio Pascual Predictive factors for non-diabetic nephropathy in diabetic patients. The utility of renal biopsy Nefrología (English Edition) Renal biopsy Diabetes mellitus Non-diabetic nephropathy Diabetic nephropathy |
| title | Predictive factors for non-diabetic nephropathy in diabetic patients. The utility of renal biopsy |
| title_full | Predictive factors for non-diabetic nephropathy in diabetic patients. The utility of renal biopsy |
| title_fullStr | Predictive factors for non-diabetic nephropathy in diabetic patients. The utility of renal biopsy |
| title_full_unstemmed | Predictive factors for non-diabetic nephropathy in diabetic patients. The utility of renal biopsy |
| title_short | Predictive factors for non-diabetic nephropathy in diabetic patients. The utility of renal biopsy |
| title_sort | predictive factors for non diabetic nephropathy in diabetic patients the utility of renal biopsy |
| topic | Renal biopsy Diabetes mellitus Non-diabetic nephropathy Diabetic nephropathy |
| url | http://www.sciencedirect.com/science/article/pii/S2013251416301250 |
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