Prevalence of non-diabetic renal disease in type 2 diabetic patients in a diabetes centre in Southern India.

ABSTRACT

OBJECTIVE: The Aim of Study is to determine the prevalence of non-diabetic renal disease among South Indian type 2 diabetic subjects based on renal biopsy. METHODS: Three thousand five hundred and ninety subjects with complete records were included for the study. One hundred and forty subjects who had proteinuria but no evidence of retinopathy undertook a 24 hour proteinuric estimation. Of these 140 subjects, 28 subjects had proteinuria > 1,000 mg/day and were subjected to renal imaging. Seven subjects were excluded due to renal calculi, cysts or contracted kidneys. Of the remaining 21 diabetic subjects, one subject was excluded as he had a mild diabetic retinopathy on fundus fluorescein angiography. Of the 20 subjects included 18 participated in the renal biopsy study (response rate--90%). Renal pathology of these subjects were studied. RESULTS: Of the 18 renal biopsies, two were excluded due to different reasons. Out of 16 patients, eight (50%) had pathological changes suggestive of diabetic etiology, five (33.3%) had classical membranous nephropathy, one (6.2%) had tubulo-interstitial disease and two (12.5%) were categorized as others with minimal changes. The subjects with non-diabetic renal disease had significantly higher creatinine clearance (p = 0.024), serum cholesterol (p = 0.036), triglyceride levels (p = 0.045) and LDL cholesterol (p = 0.048) compared to subjects with diabetic nephropathy. CONCLUSION: This study suggests that even in subjects clinically suspected to have non-diabetic renal disease many may turn out to have diabetic nephropathy on renal biopsy.