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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
The coexistence of non-diabetic kidney disease (NDKD) and diabetic kidney disease (DKD) poses significant clinical challenges. Traditional indications for biopsy are unreliable, standard remission criteria can be unattainable, and treatment is often complicated by adverse effects related to comorbid diabetes. We aim to illustrate these dilemmas through a diverse case series.
We present a retrospective analysis of three patients with type 2 diabetes who underwent kidney biopsy for significant proteinuria. The cases revealed distinct pathologies: phospholipase A2 receptor (PLA2R)-positive membranous nephropathy (MN), PLA2R-negative MN superimposed on DKD, and IgA nephropathy (IgAN).
Case 1 (PLA2R-positive MN), biopsied for rapid onset of symptoms despite retinopathy, showed a relapsing/refractory course with persistently elevated PLA2R antibodies after modified Ponticelli, IV rituximab, and is now on Tacrolimus with worsening glycemic control.
Case 2 (PLA2R-negative MN with DKD), presenting with proteinuria but no retinopathy, achieved >65% proteinuria reduction with Rituximab, but baseline DKD proteinuria made standard remission criteria inapplicable.
Case 3 (IgAN) responded to corticosteroids but developed worsening hyperglycemia, relapsed on taper, and had a fungal UTI after starting an SGLT2 inhibitor, requiring its discontinuation.
These cases demonstrate clinical-pathological discordance and highlight the therapeutic tightrope of managing immunosuppression and its complications in diabetic patients
A low threshold for kidney biopsy is crucial for patients with diabetes and significant proteinuria, irrespective of clinical predictors. Management requires personalization based on the specific NDKD. We propose that remission in dual pathology be defined by relative proteinuria reduction and highlight the urgent need for strategies to mitigate treatment-related complications, such as steroid-induced hyperglycemia and infection risk with SGLT2 inhibitors in immunosuppressed individuals.
