Non-Diabetic Kidney Disease in Type 2 Diabetes Mellitus: A Study of 82 Patients and Review of the Literatures  

作　　者：Ehab Mohammed Issa Al Salmi Dawood Al Riyami Saif Khan Marwa Al Riyami Fatma Al Rahbi Suad Hannawi Ehab Mohammed;Issa Al Salmi;Dawood Al Riyami;Saif Khan;Marwa Al Riyami;Fatma Al Rahbi;Suad Hannawi(The Renal Medicine Department, The Royal Hospital, Muscat, Oman;The Medicine Department, Oman Medical Specialty Board, Muscat, Oman;The Renal Medicine Department, SQUH, Muscat, Oman;The Pathology Department, SQUH, Muscat, Oman;The Medicine Department, MOHAP, Dubai, UAE)

机构地区：[1]The Renal Medicine Department, The Royal Hospital, Muscat, Oman [2]The Medicine Department, Oman Medical Specialty Board, Muscat, Oman [3]The Renal Medicine Department, SQUH, Muscat, Oman [4]The Pathology Department, SQUH, Muscat, Oman [5]The Medicine Department, MOHAP, Dubai, UAE

出　　处：《Open Journal of Nephrology》2022年第1期169-186,共18页肾脏病（英文）

摘　　要：Background: Worldwide, diabetic nephropathy-DN is the leading cause of end-stage kidney disease-ESKD, DN is a common cause of renal failure with a reported frequency of 10% - 15% in type-2-diabetes-mellitus-T2DM patients, however there is a great discrepancy between countries. The aim of the pre-sent study is to evaluate the findings of kidney biopsies performed on diabetic patients. Materials and Methods: We studied native kidney histopathological findings in the period from January 2016 till end of December 2018 done for patients with T2DM with chronic kidney diseases-CKD. Results: A total of 82 DM-patients, 50 males (61%) and 32 females (39%) with age mean (95% CI) of 50.8 (47.1 - 55.2) years for all patients, ranged between 15 to 65 years. Histological findings showed that 57.3% of patients had DN. While focal-segmental-glomerulosclerosis-FSGS was present in 20.7%—primary in 8.6% and secondary in 12.1%. IgA represented 4.9%, while Lupus nephritis, Membranous and drug induced interstitial nephritis were each present in 3.7%. MCD was present in 2.4%. Lastly diffuse proliferative GN, ANCA associated glomerulonephritis, and hypertensive nephrosclerosis accounted for 1.2%. Conclusion: The prevalence of NDKD is remarkably frequent in DM patients who underwent kidney biopsy and FSGS was the most frequent diagnosis. To get a proper histopathological diagnosis, an adequate tissue biopsy is needed with an adequate number of glomeruli. There is a great need for more consideration to biopsy diabetic patients, as the finding of NDKD requires a different therapeutic approach. This, hopefully, will help to manage these patients better and therefore, ameliorate the progression to ESKD over time and therefore delay the need for RRT.Background: Worldwide, diabetic nephropathy-DN is the leading cause of end-stage kidney disease-ESKD, DN is a common cause of renal failure with a reported frequency of 10% - 15% in type-2-diabetes-mellitus-T2DM patients, however there is a great discrepancy between countries. The aim of the pre-sent study is to evaluate the findings of kidney biopsies performed on diabetic patients. Materials and Methods: We studied native kidney histopathological findings in the period from January 2016 till end of December 2018 done for patients with T2DM with chronic kidney diseases-CKD. Results: A total of 82 DM-patients, 50 males (61%) and 32 females (39%) with age mean (95% CI) of 50.8 (47.1 - 55.2) years for all patients, ranged between 15 to 65 years. Histological findings showed that 57.3% of patients had DN. While focal-segmental-glomerulosclerosis-FSGS was present in 20.7%—primary in 8.6% and secondary in 12.1%. IgA represented 4.9%, while Lupus nephritis, Membranous and drug induced interstitial nephritis were each present in 3.7%. MCD was present in 2.4%. Lastly diffuse proliferative GN, ANCA associated glomerulonephritis, and hypertensive nephrosclerosis accounted for 1.2%. Conclusion: The prevalence of NDKD is remarkably frequent in DM patients who underwent kidney biopsy and FSGS was the most frequent diagnosis. To get a proper histopathological diagnosis, an adequate tissue biopsy is needed with an adequate number of glomeruli. There is a great need for more consideration to biopsy diabetic patients, as the finding of NDKD requires a different therapeutic approach. This, hopefully, will help to manage these patients better and therefore, ameliorate the progression to ESKD over time and therefore delay the need for RRT.

关 键 词：Diabetic Nephropathy Diabetic Kidney Disease HISTOPATHOLOGY Light Microscopy Electron Microscopy IMMUNOFLUORESCENCE Non-Diabetic Kidney Diseases Renal Replacement Therapy (RRT) 

分 类 号：R69[医药卫生—泌尿科学]