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Diabetic nephropathy without hyperglycemia.

J Macrae1, A Nicastri, C K Chen

  • 1Department of Medicine, SUNY Health Science Center, Brooklyn 11203.

The Journal of Diabetic Complications
|July 1, 1990
PubMed
Summary
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Diabetic nephropathy, a kidney disease, can occur without high blood sugar (hyperglycemia) in some susceptible individuals. Men and Black individuals may face a higher risk of this condition.

Area of Science:

  • Nephrology
  • Endocrinology
  • Diabetology

Background:

  • Diabetic nephropathy is a common complication of diabetes mellitus.
  • It is characterized by kidney damage, often leading to end-stage renal disease (ESRD).
  • Diagnosis typically relies on evidence of diabetes and characteristic kidney pathology.

Observation:

  • Three cases of biopsy-proven diabetic nephropathy in nephrotic patients without a prior diabetes history are presented.
  • Patients exhibited varying degrees of retinopathy and renal insufficiency.
  • Kidney biopsies revealed diffuse and nodular glomerulosclerosis without immunoglobulin light chain deposition.

Findings:

  • Fasting serum glucose and oral glucose tolerance tests were normal in the presented cases.
  • A literature review identified 23 similar cases, with five showing no hyperglycemia.

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  • Men (65%) and Black individuals (42%) were disproportionately represented in the reviewed cases.

    • Implications:

    • Diabetic nephropathy can manifest in the absence of detectable hyperglycemia in a subset of susceptible individuals.
    • This suggests alternative pathways or extreme susceptibility to diabetes-induced kidney damage.
    • Men and Black individuals may represent populations at increased risk for this atypical presentation.