Non-Diabetic Kidney Disease Confirmed by Biopsy in Patients with Diabetes: A Single-Center Registry Report

Diabetic kidney disease (DKD) is a major complication of  diabetes  mellitus  (DM),  often  leading  to  kidney  failure.  This study was designed to assess the prevalence and clinicopathological correlations  of  biopsy-confirmed  non-diabetic  kidney  disease (NDKD) in patients with diabetes.

A  retrospective  analysis  was  conducted  by  including 547  diabetic  patients  who  underwent  kidney  biopsies.  Data  on demographics,  laboratory  results  (including  serum  creatinine and urine protein levels), clinical symptoms, medical history, and histopathological diagnoses were collected.

Among the patients, 261 (47.7%) were diagnosed with DKD, while 286 (52.3%) had NDKD. The most prevalent histopathologicalfinding  in  NDKD  was  membranous  glomerulonephritis  (13.9%), followed  by  focal  and  segmental  glomerulosclerosis  (9.7%)  and IgA nephropathy (5.7%). Key predictors for DKD included longer duration  of  diabetes  mellitus  (odds  ratio  [OR]:  1.12),  elevated HbA1c  levels  (OR:  1.26),  and  the  presence  of  retinopathy  at  the time of biopsy (OR: 7.97), all with P < .05. No significant differences were  observed  in  the  frequency  of  hematuria  between  the  DKD and NDKD groups.

Membranous glomerulonephritis was the most common diagnosis  among  NDKD  patients.  The  findings  suggest  a  strong correlation between the duration of diabetes mellitus, the presence of retinopathy, and HbA1c levels with DKD development, indicating a need for revised criteria for kidney biopsy decisions in diabetic individuals to enhance diagnostic accuracy and treatment strategies.