BACKGROUND/
AIMS:
In several recent studies, renal
biopsies in
patients with
type 2 diabetes and renal
disease have revealed a heterogeneous group of
disease entities. Our aim was to study the
prognosis and
clinical course of nondiabetic renal
disease (NDRD) and to determine
risk factors for NDRD in
patients with
type 2 diabetes.
METHODS:
Renal
biopsy reports of 110
patients with
type 2 diabetes who were seen at Kyung Hee
University Medical Center and Kyung Hee
University Hospital at Gangdong,
Seoul,
Korea between January 2000 and December 2011 were retrospectively analyzed.
RESULTS:
Of 110
patients with
type 2 diabetes, 41 (37.3%) had
diabetic nephropathy (DN), 59 (53.6%) had NDRD, and 10 (9.1%) had NDRD superimposed on DN.
Immunoglobulin A nephropathy (43.5%) was the most common NDRD.
Patients with NDRD had a shorter duration of diabetes, lower frequency of
diabetic retinopathy, and better renal outcomes, which might have resulted from the use of aggressive
disease-specific
treatments such as
steroids and
immunosuppressants in
patients with NDRD.
CONCLUSIONS:
Compared with DN, NDRD was associated with better renal outcomes in
patients with
type 2 diabetes, as evidenced by a higher cumulative renal
survival rate and lower rate of
end-stage renal disease (
ESRD). Shorter duration of diabetes and absence of retinopathy were independent predictors of NDRD in
patients with
type 2 diabetes and renal involvement. Renal
biopsy is recommended for
patients with
type 2 diabetes and
risk factors for NDRD, to obtain an accurate
diagnosis, prompt initiation of
disease-specific
treatment, and ultimately better renal outcomes with the avoidance of
ESRD.