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Membranous nephropathy occurring with type 2 diabetes mellitus
Clinical Nephrology
|January 28, 2017
Summary
Type 2 diabetes mellitus (T2DM) and membranous nephropathy (MN) frequently coexist. Diabetic MN presents with more severe kidney lesions, but remission rates are similar to non-diabetic MN patients.
Area of Science:
- Nephrology
- Endocrinology
- Diabetology
Background:
- Increasing incidence of type 2 diabetes mellitus (T2DM).
- Membranous nephropathy (MN) is a common renal complication in T2DM.
- Investigating clinicopathological features and outcomes of T2DM patients with MN.
Purpose of the Study:
- To investigate the clinicopathological features and outcomes of patients with T2DM and MN.
- To compare MN patients with and without diabetes mellitus.
Main Methods:
- Retrospective study of 137 patients with biopsy-proven MN and T2DM.
- 100 MN patients without diabetes mellitus served as a control group.
- Analysis of clinicopathological features, treatment responses, and outcomes.
Main Results:
- Isolated MN (D group) in 86 patients; MN superimposed on diabetic nephropathy (DN) (DN group) in 51 patients.
- Diabetic MN patients were older, more frequently hypertensive, and had more severe global glomerulosclerosis, interstitial fibrosis/tubular atrophy (IFTA), and afferent arteriolar lesions.
- Male gender, longer diabetes duration, and diabetic retinopathy were independent predictors of DN; complete remission rates were similar between groups.
Conclusions:
- Diabetic MN typically affects older, hypertensive individuals and shows distinct histological features.
- Patients with pure MN and diabetes can achieve remission.
- Male gender, diabetes duration, and retinopathy indicate DN development.
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