Abstract

Dr. Vamshi Krishna*, Dr. Manjusha Yadla, Dr. Srinivas P

ABSTRACT

Diabetic kidney disease (DKD) is characterized by persistent proteinuria, hypertension, and a progressive decline in renal function and is the leading cause of end-stage kidney disease worldwide. About 30%-40% of patients with diabetes usually present with frank diabetic nephropathy characterized histologically by nodular or diffuse mesangial sclerosis, arteriolar hyalinosis, microaneurysms, and exudative lesions. In patients with Type 2 diabetes mellitus (T2 DM), NON -Diabetic Kidney Diseases(NDKD) can occur either in isolation or superimposed on DKD.[2] The timely diagnosis of NDKD in this group is of paramount importance as many NDKD can be successfully treated and improve the overall renal prognosis. Short of biomarkers, as of now, kidney biopsy is the gold standard in diagnosing NDKD in T2 DM patients.[1] Published literature has shown varying prevalence of NDKD that could be attributed to the differences in the various criteria adopted by the clinicians to subject a patient to kidney biopsy. The diagnosis of presumed DKD is mainly clinically based on the presence of long-standing diabetes with the presence of retinopathy. Several clinical parameters have been used by physicians to suspect NDKD in T2 DM, including rapid-onset proteinuria, massive proteinuria, lack of retinopathy, presence of hematuria, active urine sediments, rapid decline of renal function, and features suggestive of systemic disease. However, no consensus exists, and the decision to proceed for the kidney biopsy depends on treating physician’s clinical judgment.[2] In this study, we retrospectively reviewed kidney biopsies from patients with T2 Diabetes Mellitus and reported the prevalence and factors predicting the presence of NDKD in T2 DM.