title: Evaluation of renal biopsies in type 2 diabetic patients with kidney disease: a clinicopathological study of 216 cases.
abstract: OBJECTIVE
  The outcome and the therapy of patients with diabetes mellitus (DM), diabetic nephropathy (DN), and non-diabetic renal disease (NDRD) are quite different, so the differential diagnosis is of considerable importance. To evaluate the usefulness of renal biopsy in type 2 diabetic patients, we examined the relationship between the clinical parameters and the histopathological findings in different age groups.
  
  
  METHODS
  Renal biopsy specimens and clinical and laboratory data from 216 patients with type 2 DM were evaluated. According to their age, three groups were defined: 17-35 years (group I), 36-59 years (group II), and more than 60 years (group III).
  
  
  RESULTS
  The study showed that, beside the duration of diabetes, other clinical parameters were not significantly different between the three groups. Chronic nephritic syndrome was the most common clinical manifestation in group I (44.1 %) and in group II (34.0 %). Among patients in group III, we found a high prevalence of chronic renal failure (34.3 %) and nephrotic syndrome (28.6 %). Consistent with the clinical manifestations, IgA nephropathy was the most common pathologic finding in group I (29.4 %) and in group II (34.7 %), whereas the most frequent abnormalities in group III were membranous nephropathy (25.7 %) and tubulointerstitial lesions (14.3 %). Overall, among these patients, 14 cases were diagnosed with DN (6.5 %), 179 with NDRD (82.9 %), while 23 had concurrent DN and NDRD (10.7 %).
  
  
  CONCLUSIONS
  Our results indicated that the clinical manifestations and pathologic findings in type 2 diabetic patients in different age groups have different features. This study emphasized the usefulness of renal biopsy for determining the pattern of renal damage and thus for the overall management of type 2 diabetic patients.
authors.affiliation: Department of Nephrology, Chinese-Japanese Friendship Hospital, 2 East Yinghuayuan Street, Hepingli, Beijing 100029, People's Republic of China.
authors.forename: Li
authors.initials: L
authors.lastname: Zhuo
authors.forename: Wenwen
authors.initials: W
authors.lastname: Ren
authors.forename: Wenge
authors.initials: W
authors.lastname: Li
authors.forename: Guming
authors.initials: G
authors.lastname: Zou
authors.forename: Jianhua
authors.initials: J
authors.lastname: Lu
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001706:Biopsy; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003928:Diabetic Nephropathies / Q000209:etiology / Q000473:pathology*; D003937:Diagnosis, Differential; D005922:Glomerulonephritis, IGA / Q000473:pathology; D015433:Glomerulonephritis, Membranous / Q000473:pathology; D006801:Humans; D007668:Kidney / Q000473:pathology*; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000473:pathology*; D051436:Renal Insufficiency, Chronic / Q000473:pathology*; D018709:Statistics, Nonparametric; D055815:Young Adult