Abstract: SA-PO283

Diversity of Biopsy-Proven Kidney Diseases in Thai Diabetic Patients: Analysis of Thai Glomerular Disease Collaborative Network (TGCN)

Session Information

Category: Glomerular

  • 1005 Clinical Glomerular Disorders

Authors

  • Nimkietkajorn, Veerapatr, Buddhachinaraj hospital, Phitsanulok, Thailand
  • Chawanasuntorapoj, Ratana, Siriraj Hospital, Bangkok, Thailand
  • Tantranont, Ngoentra, Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • Sangthawan, Pornpen, Prince of Songkla University Hospital, Songkhla, Thailand
  • Pichaiwong, Warangkana, RAJAVITHI HOSPITAL, Bangkok, Thailand

Group or Team Name

  • Thai Glomerular Disease Collaborative Network (TGCN)
Background

Diabetic nephropathy (DN) is the leading cause of chronic kidney disease worldwide including Thailand. However, there is also increasing recognized diagnosis of non-diabetic renal diseases (NDRD) in diabetic patients, which may influence in the different treatments and outcomes. This study reported the spectrum and clinical characteristics of NDRD and NDRD superimposed DN in Thai diabetic population.

Methods

Clinical data of the diabetic patients with aged > 18 years undergone kidney biopsy were collected via the nationwide web-based Thai glomerular diseases registry from TGCN during 2014-2017. These data including the demographic data and laboratory data together with kidney biopsy pathological findings.

Results

The 276 from 1,556 patients were recruited in this study; 123 cases were male (44.6%). The mean age was 51.8+years, and the median serum creatinine was 1.99 mg/dL (0.42-13.2). The 114 cases (41.3%) were diagnosed NDRD, while 23 cases (8.3%) were diagnosed NDRD superimposed DN. The rest of the patients were diagnosed isolated diabetic nephropathy; DN (50.4%). FSGS was either the most prevalent glomerular disease in both NDRD (23.7%) and NDRD superimposed DN (34.8%). The second and third kidney biopsy findings in NDRD were lupus nephritis (21.9%), IgA nephropathy (13.2%), respectively. In NDRD superimposed DN, membranous nephropathy (26.1%), and post-infectious glomerulonephritis (21.7%) were the second and third pathological findings. Nephritis was the clinical presentation of NDRD and NDRD superimposed DN approximately 15.8% and 13%, whereas it was not found in DN. Nephrotic syndrome was more common in DN and NDRD superimposed DN than in NDRD (80.6%, 73.9%, and 37.7%, respectively, p<0.05). Moreover, the quantity of proteinuria was found to be higher in DN and NDRD superimposed DN than in NDRD (6.4, 6.5, and 3.7 g/day, respectively, p<0.05).

Conclusion

This report disclosed the diversity and prevalence of NDRD that was diagnosed in more than one-third of Thai diabetic patients. Presence of nephritis was the more suggestive diagnosis of NDRD or NDRD superimposed DN. However, kidney biopsy is still the important means for the definite diagnosis of glomerular disease in diabetic patients.

Funding

  • Private Foundation Support