Non-Diabetic Renal Disease in Patients with Type 2 Diabetes Mellitus with Proteinuria

• 作者: A. K. M. Shahidur Rahman Abu Zafor Md. Salahuddin Fahad Al Shatil Ashrafee K. B. M. Hadiuzzaman Manik Chandra Mondal Md. Omar Faroque Mohammad Kamrul Ahsan Popy Sarker Rana Mokarrom Hossain Shah Md. Zakir Hossain
• 来源期刊: 生物科学与医学(英文)
• 学科: 医学
• 关键词: Diabetes MELLITUS (DM) Diabetic NEPHROPATHY (DN) NON-DIABETIC RENAL Disease (NDRD) RENAL BIOPSY
• 年，卷（期）: 2019,（12）
• 页码范围: 68-78
• 页数: 11页
• 分类号: R58

摘要

Background: Diabetes mellitus (DM) is the leading cause of end stage renal disease (ESRD) worldwide. Although DM with proteinuria is the ultimate result of diabetic nephropathy (DN), a wide spectrum of non-diabetic renal diseases (NDRD) can occur in such patients. Objective: To observe the frequency and histological pattern of NDRD in diabetic patients with proteinuria and to explore their association with clinical and laboratory parameters. Methods: This cross-sectional study was conducted in the Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from April 2016 to September 2017. In this study a total of 38 cases of DM with proteinuria (>1 gm/24-hour) were selected purposively. Renal biopsy was done in all patients. Based on histological findings they were categorized into two groups;Group 1 with NDRD and Group II with DN. Their clinical and laboratory parameters were analyzed and compared. Results: Among the total study subjects, 21 (55.3%) were male and 17 (44.7%) were female, mean (±SD) age 43.45 ± 9.99 years in the NDRD group and 41.57 ± 9.50 years in the DN group. Thirty one cases (81.6%) out of thirty eight had NDRD and seven (18.4%) cases had isolated DN;therefore more than two third cases had NDRD. Duration of DM was found to be significantly shorter (p = 0.004) in the NDRD group. Diabetic retinopathy was present in 12.9% cases in NDRD group vs. 57.1% cases in DN group (p = 0.025). Frequency of microscopic hematuria was significantly higher (90.3%) in NDRD patients (p = 0.002). Conclusion: The frequency of NDRD in type 2 diabetic patients other than diabetic nephropathy is relatively high. Membrano proliferative glomeru-lonephritis and membranous nephropathy are more common in NDRD. Absence of diabetic retinopathy, presence of hematuria and shorter duration of DM are markers associated with NDRD in type 2 DM, which are important indicators for renal biopsy in diabetic patients with proteinuria.