Nondiabetic Renal Disease in type 2 Diabetes Mellitus Patients: A Clinicopathological Study.
BACKGROUND
The prevalence of nondiabetic renal disease (NDRD) among type 2 diabetics varies widely depending on the populations being studied and the selection criteria. Also, for patients found to have NDRD different predicting factors have been identified by different studies.


OBJECTIVE
TO DETERMINE: (i) Frequency and spectrum of NDRD in type 2 diabetics with atypical clinical renal disease, in our set up and (ii) common clinical markers that are associated with NDRD in our local population.


METHODS
Ninety-three type 2 diabetic patients with atypical clinical renal disease who had undergone renal biopsy to rule out NDRD were recruited. Patients were grouped into Group 1 with isolated NDRD, Group 2 with NDRD superimposed on diabetic nephropathy (DN), and Group 3 with isolated DN; and their clinical and biochemical parameters were statistically analyzed using analysis of variance, Kruskal-Wallis test, and Chi-square tests of statistical significance.


RESULTS
68.8% of the patients had NDRD with or without concurrent DN. Patients with isolated NDRD had shorter duration of diabetes compared to the other groups. Absence of retinopathy and presence of microscopic hematuria and active urinary sediment had positive predictive value of 79.24, 81, and 100%, respectively, for NDRD in type 2 diabetics. Chronic interstitial nephritis was the commonest NDRD and membranous glomerulonephritis was the commonest glomerular NDRD in our setup.


CONCLUSIONS
The frequency of NDRD in type 2 diabetics with atypical clinical renal disease is high in our setup thereby making the renal biopsy procedure imperative to rule out the same. Shorter duration of diabetes, absence of retinopathy, presence of microscopic hematuria, and active urinary sediment are markers associated with NDRD in type 2 diabetes with clinical renal disease.
Department of Pathology, M. S. Ramaiah Medical College and Teaching Hospital, Bangalore, Karnataka, India.
Devadass Clement
DC
Wilfred
Department of Pathology, M. S. Ramaiah Medical College and Teaching Hospital, Bangalore, Karnataka, India.
Vijaya Viswanath
VV
Mysorekar
Department of Nephrology, M. S. Ramaiah Medical College and Teaching Hospital, Bangalore, Karnataka, India.
Raju S
RS
Venkataramana
Department of Nephrology, M. S. Ramaiah Medical College and Teaching Hospital, Bangalore, Karnataka, India.
Mahesh
M
Eshwarappa
Department of Pathology, M. S. Ramaiah Medical College and Teaching Hospital, Bangalore, Karnataka, India.
Revathi
R
Subramanyan
Diabetic nephropathy; hematuria; nondiabetic renal disease; retinopathy