title: Do we have to perform a renal biopsy? Clinical dilemmas in a case with nephrotic syndrome.
abstract: Renal biopsy is one of the pivotal diagnostic tools used in the field of nephrology. A morphological analysis of the kidney may also be of value for the overall management of patients with diabetic nephropathy. However, the indications for renal biopsy differ considerably among nephrologists, and no global consensus regarding performing this procedure among diabetic patients with various renal manifestations has yet been achieved. In this report, we would like to describe our serendipitous experience with a male type 2 diabetic patient presenting with nephrotic syndrome complicated by concurrent gastric carcinoma. We also discuss several conundrums that arose in the current case, which had an impact on our diagnostic and therapeutic decisions.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan.
authors.forename: Tetsu
authors.initials: T
authors.lastname: Akimoto
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Otani
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan.
authors.forename: Eri
authors.initials: E
authors.lastname: Takeshima
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Saito
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Kusano
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Nagata
keywords: diabetic nephropathy; membranous nephropathy; nephrotic syndrome; paraneoplastic glomerular injury; renal biopsy