PMID- 36836240
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230918
IS  - 2077-0383 (Print)
IS  - 2077-0383 (Electronic)
IS  - 2077-0383 (Linking)
VI  - 12
IP  - 4
DP  - 2023 Feb 20
TI  - Non-Diabetic Kidney Disease in Type 2 Diabetes Mellitus: A Changing Spectrum with 
      Therapeutic Ascendancy.
LID - 10.3390/jcm12041705 [doi]
LID - 1705
AB  - BACKGROUND AND OBJECTIVES: Owing to changing epidemiology and therapeutic 
      practices, a change in the spectrum of renal involvement in Type-2 diabetes 
      mellitus (T2DM) has also been noted. The treatment of non-diabetic kidney disease 
      (NDKD) differs from diabetic kidney disease (DKD) and the reversibility of NDKD 
      in many cases to normal, prompts biopsy for rapid and accurate diagnosis. Data 
      are scarce on kidney biopsy findings in T2DM. STUDY DESIGN & SETTING: In this 
      observational study, we prospectively collected the data of kidney biopsies of 
      patients aged >/= 18 years with T2DM admitted between 1 August 2005 and 31 July 
      2022. The clinical, demographic and histopathological data were evaluated. The 
      spectrum of kidney involvement in the form of DKD and/or NDKD was studied. The 
      impact of these findings with the use of drugs retarding disease progression was 
      also analyzed. RESULTS: A total of 5485 biopsies were performed during the study 
      period and of these 538 patients had T2DM. The mean age of the study population 
      was 56.9 +/- 11.5 years and 81% were males. The mean duration of DM was 6.4 +/- 6.1 
      years. Diabetic retinopathy (DR) was noted in 29.7%. The most common indication 
      for biopsy was an acute rise in creatinine (147, 27.3%). Amongst the 538 diabetic 
      patients who underwent biopsy, histological features only of DKD were noted in 
      166 patients (33%), NDKD alone in 262 (49%) and NDKD with DKD lesions in 110 
      (20%). On multivariate analysis, duration of DM less than 5 years, absence of 
      CAD, absence of DR, oliguria at presentation, an acute rise in creatinine and low 
      C3 were associated with NDKD. CONCLUSIONS: The prevalence of NDKD among diabetics 
      and ATIN in particular might be on an increasing trend in the current era of 
      changing T2DM epidemiological patterns. The use of anti-pro-teinuric agents was 
      associated with lesser degrees of histopathological chronicity in T2DM.
FAU - Prasad, Narayan
AU  - Prasad N
AUID- ORCID: 0000-0001-9801-0474
AD  - Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical 
      Sciences, Lucknow 226014, India.
FAU - Veeranki, Vamsidhar
AU  - Veeranki V
AD  - Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical 
      Sciences, Lucknow 226014, India.
FAU - Bhadauria, Dharmendra
AU  - Bhadauria D
AD  - Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical 
      Sciences, Lucknow 226014, India.
FAU - Kushwaha, Ravi
AU  - Kushwaha R
AD  - Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical 
      Sciences, Lucknow 226014, India.
FAU - Meyyappan, Jeyakumar
AU  - Meyyappan J
AD  - Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical 
      Sciences, Lucknow 226014, India.
FAU - Kaul, Anupama
AU  - Kaul A
AD  - Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical 
      Sciences, Lucknow 226014, India.
FAU - Patel, Manas
AU  - Patel M
AD  - Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical 
      Sciences, Lucknow 226014, India.
FAU - Behera, Manas
AU  - Behera M
AUID- ORCID: 0000-0002-2756-117X
AD  - Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical 
      Sciences, Lucknow 226014, India.
FAU - Yachha, Monika
AU  - Yachha M
AD  - Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical 
      Sciences, Lucknow 226014, India.
FAU - Agrawal, Vinita
AU  - Agrawal V
AUID- ORCID: 0000-0003-1806-7142
AD  - Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical 
      Sciences, Lucknow 226014, India.
FAU - Jain, Manoj
AU  - Jain M
AD  - Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical 
      Sciences, Lucknow 226014, India.
LA  - eng
PT  - Journal Article
DEP - 20230220
PL  - Switzerland
TA  - J Clin Med
JT  - Journal of clinical medicine
JID - 101606588
PMC - PMC9964578
OTO - NOTNLM
OT  - diabetic kidney diseases
OT  - histological changes
OT  - non-diabetic kidney disease
OT  - type 2 diabetes mellitus
COIS- The authors declare no conflict of interest, except NP has received the study 
      grant from the department of health and research, Indian Council of Medical 
      Research, MOHF, Government of India, for other research projects.
EDAT- 2023/02/26 06:00
MHDA- 2023/02/26 06:01
PMCR- 2023/02/20
CRDT- 2023/02/25 03:09
PHST- 2023/01/17 00:00 [received]
PHST- 2023/02/12 00:00 [revised]
PHST- 2023/02/15 00:00 [accepted]
PHST- 2023/02/25 03:09 [entrez]
PHST- 2023/02/26 06:00 [pubmed]
PHST- 2023/02/26 06:01 [medline]
PHST- 2023/02/20 00:00 [pmc-release]
AID - jcm12041705 [pii]
AID - jcm-12-01705 [pii]
AID - 10.3390/jcm12041705 [doi]
PST - epublish
SO  - J Clin Med. 2023 Feb 20;12(4):1705. doi: 10.3390/jcm12041705.