HISTOPATHOLOGICAL FINDINGS IN THE RENAL BIOPSY OF NATIVE KIDNEYS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS (T2-DM)

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https://storage.unitedwebnetwork.com/files/1099/d8b6d7a63375276618f0e2ef8926e0b0.pdf

Abstract Title

First Name *

Sofia

Last Name *

San Román

Co-author 1

Valentina Sorondo valentinasorondo.vsb@gmail.com Centro de Nefrología, Hospital de Clínicas, Facultad de Medicina Nefrologia Montevideo

Co-author 2

Ricardo Silvariño rsilvarino@gmail.com Centro de Nefrología, Hospital de Clínicas, Facultad de Medicina Nefrologia Montevideo

Co-author 3

Cecilia Baccino baccinocecilia@yahoo.com Centro de Nefrología, Hospital de Clínicas, Facultad de Medicina Nefrologia Montevideo

Co-author 4

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Introduction

T2-DM and chronic kidney disease (CKD) are common pathologies, with a high prevalence in adult population. Diabetic kidney disease (DKD) can present clinically with different phenotypes. The high frequency of T2-DM, CKD and DKD creates difficulty in establishing an accurate diagnosis in patients with T2-DM and manifestations of glomerular disease. Multiple studies report the presence of non-diabetic nephropathy (NDN) in 35-75% of renal biopsies (RB) from patients with T2-DM. The aim of the present study is describe the histopathological findings and their clinical correlation, in patients with T2-DM in whom RB was performed in Uruguay.

Methods

Patients with T2-DM were selected from the database of the Uruguayan renal health program (URHP), in which are included patients with CKD according to KDIGO criteria. The data was crossed with the URG database (patients with renal biopsy performed between 1985-2020) and a group of patients with T2-DM and RB was included. Histopathological findings were analyzed, and the clinical record was reviewed in search of data on the clinical presentation at the time of RB (figure 1).

Results

Histopathological and clinical data were obtained from 190 patients with T2-DM and RB from native kidneys. Table 1 shows the clinical-laboratory features at the time of RB, and the indication for which it was performed.

Conclusions

Conclusions. NDN was a frequent finding in patients with DM-2 with RB (88%) in our cohort. Clinical presentation such as NiS, AUD and RPKF had little association with the finding of DN pattern. The frequency of other glomerulopathies in patients with NDN presented a similar profile that population without T2-DM biopsied in the same period of time in the country, according to the incidence rate (n/1000000population/year) reported in the national registry: EHSF: 13.4, Vasculitis: 11.7, N-IgA: 11.7, N-Membranous: 9.4, N-Lupus: 9.6, LGM: 5.1. Given the frequency of T2-DM in the adult population and variability in the clinical presentation of DKD, clear criteria for RB in patients with T2-DM must be established to make a diagnosis of other GPs that require a different therapeutic approach.

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