The Spectrum Of Kidney Disease In Type Two Diabetic Patients A Single-Center Study

Background:Diabetic nephropathy(DN)is the dominant reason for end-stage kidney disease linked with a rise in cardiovascular mortality rate.However,besides DN,type 2 diabetic patients may also suffer from various non-diabetic renal diseases(NDRD).Aim:The objective of the current research was to assess the occurrence and type of NDRD diagnosed by kidney biopsy in type 2 diabetic subjects,evaluate the association of various clinical and laboratory characteristics with histopathology findings,and identify essential predictors of NDRD.Methods:Retrospective analysis has been performed through medical record revision of 101 patients with type 2 diabetes undergoing percutaneous renal biopsy at Qilu Hospital of Shandong University(Jinan,China)between January 2015 and December 2020.Results:Renal biopsy results showed that NDRD was found in 59 patients(58.42%),while DN existed in 32 patients(31.68%)and 10 patients(9.90%)showed DN complicated with NDRD.Membranous nephropathy was prevailing NDRD(42%),followed by focal segmental glomerulosclerosis(11.6%)and IgA nephropathy(10.1%).In univariate analysis,patients with NDRD had older age(p<0.018),a short duration of diabetes(p<0.000),lower proteinuria(p<0.030),and had higher hemoglobin levels(p<0.006)compared to non-NDRD patients.In multivariate logistic regression analysis,the short course of diabetes(OR 0.986;95%CI=0.978-0.993;p=0.000)and older age(OR 1.080;95%CI=1.028-1.134;p=0.002)were significant risk factors for NDRD occurrence.In ROC analysis for NDRD,the duration of diabetes ≤78 months(cut-off value(0.725,0.313))illustrated the highest AUC.Conclusions:Clinical parameters such as short duration of diabetes,older age,higher hemoglobin level,and lower proteinuria might be associated with NDRD in type 2 diabetic patients.An early diagnosis of NDRD poses a favorable renal prognosis because it requires a different approach than DN,further larger multicenter randomized prospective investigations focused on identifying possible risk markers of NDRD are still in priority.