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Correlation of microproteinuria and histopathological changes in kidney in diabetes mellitus
D S Jhondhale1, S Bhatia, J C Patel
1Sassoon Hospital.
Abstract:
Single attempt kidney biopsy was successful in 60 cases of diabetes mellitus out of 83. Histopathological evidence of nephropathy was found in 30 (50%) out of 60 (4 of IDDM and 56 of NIDDM). Microproteinuria was a sensitive indicator of histopathological evidence of nephropathy (by biopsy) and should be used as a non invasive method of evidence of kidney involvement in diabetes mellitus regardless of duration of the disease. Routine renal function tests--commonly used indicators of kidney disease in the presence of hypertension were of no value and should not be relied upon. Duration of diabetes mellitus was important correlation with the evidence of the disease and and its severity but nephropathy was found in newly detected cases of diabetes mellitus (NIDDM). Nephropathy was present in case of DM who had retinopathy and is a better factor of correlation.
Insights
Microproteinuria effectively indicates kidney damage in diabetes mellitus patients, even in early stages. Routine kidney function tests are unreliable for detecting diabetic nephropathy.
Area of Science:
- Nephrology
- Endocrinology
- Pathology
Background:
- Diabetic nephropathy is a major complication of diabetes mellitus.
- Early detection of kidney involvement is crucial for managing diabetes.
- Current non-invasive markers for diabetic nephropathy require further validation.
Purpose of the Study:
- To evaluate the diagnostic value of microproteinuria for detecting diabetic nephropathy.
- To assess the reliability of routine renal function tests in diabetic patients.
- To explore correlations between disease duration, retinopathy, and nephropathy in diabetes mellitus.
Main Methods:
- Kidney biopsy was performed in 83 patients with diabetes mellitus.
- Histopathological analysis identified nephropathy in biopsied kidneys.
- Microproteinuria and routine renal function tests were compared with biopsy findings.
Main Results:
- Kidney biopsy was successful in 60 cases, revealing nephropathy in 30 (50%).
- Microproteinuria demonstrated high sensitivity for detecting histopathological nephropathy.
- Routine renal function tests were not reliable indicators of kidney disease in this cohort.
Conclusions:
- Microproteinuria is a sensitive, non-invasive marker for kidney involvement in diabetes mellitus.
- Routine renal function tests should not be relied upon for diagnosing diabetic nephropathy.
- Nephropathy can occur in newly detected diabetes mellitus cases and correlates with retinopathy.