PMID- 32757123
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231112
IS  - 1869-6953 (Print)
IS  - 1869-6961 (Electronic)
IS  - 1869-6961 (Linking)
VI  - 11
IP  - 9
DP  - 2020 Sep
TI  - Insights into the Role of Renal Biopsy in Patients with T2DM: A Literature Review 
      of Global Renal Biopsy Results.
PG  - 1983-1999
LID - 10.1007/s13300-020-00888-w [doi]
AB  - INTRODUCTION: Renal biopsy performed in patients with type 2 diabetes mellitus 
      (T2DM) for atypical or suspected diabetic kidney disease (DKD) reveals one of 
      three possibilities: diabetic nephropathy (DN, pathological diagnosis of DKD), 
      nondiabetic kidney disease (NDKD) and DN plus NDKD (mixed form). NDKD (including 
      the mixed form) is increasingly being recognized worldwide. With the emerging 
      concept of DKD and the complexity of routine application of renal biopsy, the 
      identification of "clinical indicators" to differentiate DKD from NDKD has been 
      an area of active research. METHODS: The PubMed database was searched for 
      relevant articles mainly according to the keyword search method. We reviewed 
      prevalence of the three types of DKD and different pathological lesions of NDKD. 
      We also reviewed the clinical indicators used to identify DKD and NDKD. RESULTS: 
      The literature search identified 40 studies (5304 data) worldwide between 1977 
      and 2019 that looked at global renal biopsy and pathological NDKD lesions. The 
      overall prevalence rate of DN, NDKD and DN plus NDKD is reported to be 41.3, 40.6 
      and 18.1%, respectively. In Asia, Africa (specifically Morocco and Tunisia) and 
      Europe, the most common isolated NDKD pathological type is membranous 
      nephropathy, representing 24.1, 15.1 and 22.6% of cases, respectively. In 
      contrast, focal segmental glomerulosclerosis is reported to be the primary 
      pathological type in North America (specifically the USA) and Oceania 
      (specifically New Zealand), representing 22% and 63.9% of cases, respectively. 
      Tubulointerstitial disease accounts for a high rate in the mixed group (21.7%), 
      with acute interstitial nephritis being the most prevalent (9.3%), followed by 
      acute tubular necrosis (9.0%). Regarding clinical indicators to differentiate DKD 
      from NDKD, a total of 14 indicators were identified included in 42 studies. Among 
      these, the most commonly studied indicators included diabetic retinopathy, 
      duration of diabetes, proteinuria and hematuria. Regrettably, indicators with 
      high sensitivity and specificity have not yet been identified. CONCLUSION: To 
      date, renal biopsy is still the gold standard to diagnose diabetes complicated 
      with renal disease, especially when T2DM patients present atypical DKD symptoms 
      (e.g. absence of diabetic retinopathy, shorter duration of diabetes, microscopic 
      hematuria, sub-nephrotic range proteinuria, lower glycated hemoglobin, lower 
      fasting blood glucose). We conclude that renal biopsy as early as possible is of 
      great significance to enable personalized treatment to T2DM patients.
FAU - Tong, Xue
AU  - Tong X
AD  - Department of Nephrology, First Teaching Hospital of Tianjin University of 
      Traditional Chinese Medicine, Tianjin, China.
FAU - Yu, Qun
AU  - Yu Q
AD  - Department of Nephrology, First Teaching Hospital of Tianjin University of 
      Traditional Chinese Medicine, Tianjin, China.
FAU - Ankawi, Ghada
AU  - Ankawi G
AD  - Department of Internal Medicine and Nephrology, King Abdulaziz University, 
      Jeddah, Saudi Arabia.
FAU - Pang, Bo
AU  - Pang B
AD  - Department of Nephrology, First Teaching Hospital of Tianjin University of 
      Traditional Chinese Medicine, Tianjin, China.
FAU - Yang, Bo
AU  - Yang B
AD  - Department of Nephrology, First Teaching Hospital of Tianjin University of 
      Traditional Chinese Medicine, Tianjin, China. yb8203@126.com.
FAU - Yang, Hongtao
AU  - Yang H
AD  - Department of Nephrology, First Teaching Hospital of Tianjin University of 
      Traditional Chinese Medicine, Tianjin, China.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20200805
PL  - United States
TA  - Diabetes Ther
JT  - Diabetes therapy : research, treatment and education of diabetes and related 
      disorders
JID - 101539025
PMC - PMC7434810
OTO - NOTNLM
OT  - Clinical indicators
OT  - Diabetic kidney disease
OT  - Nondiabetic kidney disease
OT  - Renal biopsy
OT  - Type 2 diabetes mellitus
EDAT- 2020/08/07 06:00
MHDA- 2020/08/07 06:01
PMCR- 2020/08/05
CRDT- 2020/08/07 06:00
PHST- 2020/06/17 00:00 [received]
PHST- 2020/08/07 06:00 [pubmed]
PHST- 2020/08/07 06:01 [medline]
PHST- 2020/08/07 06:00 [entrez]
PHST- 2020/08/05 00:00 [pmc-release]
AID - 10.1007/s13300-020-00888-w [pii]
AID - 888 [pii]
AID - 10.1007/s13300-020-00888-w [doi]
PST - ppublish
SO  - Diabetes Ther. 2020 Sep;11(9):1983-1999. doi: 10.1007/s13300-020-00888-w. Epub 
      2020 Aug 5.