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Abstract

Background: The prevalence of nondiabetic renal disease (NDRD) in those with type 2 diabetes mellitus (T2DM) is common worldwide, however, data from India is limited. Methods: This study included subjects of T2DM who underwent renal biopsy with suspicion of NDRD from September 2009 to August 2016. Results: Seventy-one subjects (males: 47 [66.2%] and females:24 [33.8%]) of T2DM with mean age and standard deviation (SD) of 52.93±12.56 years were included in the study. The indications for renal biopsy included acute on chronic renal failure (ACRF) in 35.2% (25), nephrotic syndrome (NS) in 31% (22), acute renal failure (ARF) in 14.1% (10), nephritic syndrome in 14.1% (10) and others in 5.6% (4) of subjects. The prevalence rates of NDRD, diabetic nephropathy (DN) and DN with NDRD were 50.71 (36), 28.16 (20) and 21.13% (15) respectively. Among the subjects with NDRD, 69.44% (25) had primary glomerular diseases (PGDs), 16.67% (6) had tubulointerstitial diseases (TIDs) and 13.89% (5) had secondary glomerular diseases (SGDs). The IgA nephropathy (IgAN) was the commonest of the PGDs affecting 28% (7) followed by post-infective glomerulonephritis (PIGN) in 20% (5), membranous nephropathy (MN) in 16% (4), focal segmental glomerulosclerosis (FSGS) in 12% (3) and miscellaneous lesions in 24% (10). The acute interstitial nephritis (AIN) and primary amyloidosis were the commonest of TIDs and SGDs respectively. Among the patients with combination of DN with NDRD, 53.33% (8) were TIDs and 46.67% (7) had glomerular diseases. The acute tubular injury/necrosis (ATN) and PIGN were the commonest of TIDs and glomerular disease respectively. The figures in brackets representing number of patients. Conclusions: Majority of the subjects with T2DM had NDRD either alone or in combination with DN in the study, underlining the utility of renal biopsy for their diagnoses in those with appropriate indication. Wide spectrum of PGDs, TIDs and SGDs were found in the study.

 

Keywords: Type 2 Diabetes Mellitus; Non-Diabetic Renal Disease; Diabetic Nephropathy. 

Corresponding Author : Lakshminarayana G.R., Consultant Nephrologist, Department of Nephrology, EMS Memorial Cooperative Hospital and Research Centre, Perinthalmanna, Malappuram, Kerala 679322, India.