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Abstract: SA-PO534

Diversity of Biopsy-Proven Kidney Diseases in Japanese Patients with Diabetic Kidney Disease

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Authors

  • Inotani, Satoshi, Kochi University, Nankoku, Japan
  • Horino, Taro, Kochi Medical School, Kochi University, Kochi, Japan
  • Shimamura, Yoshiko, Kochi Medical School, Kochi University, Kochi, Japan
  • Fujimoto, Shimpei, Kochi University, Nankoku, Japan
  • Terada, Yoshio, Kochi Medical School, Kochi University, Kochi, Japan
Background

Diabetic kidney disease (DKD), including diabetic nephropathy (DN), is the leading cause of chronic kidney disease worldwide including Japan. 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 Japanese diabetic population.

Methods

Clinical data of the diabetic patients with aged > 18 years undergone kidney biopsy in Kochi Medical School hospital during 2001-2017 were collected. These data including the and laboratory data together with renal biopsy pathological findings.

Results

The 165 from 872 patients were recruited in this study; 108 cases were male (65.4%). The mean age was 61.1±1.1 years, and the median serum creatinine was 1.86 mg/dL (0.96-2.76). The 48 cases (29.0%) were diagnosed NDRD, while 50 cases (30.3%) were diagnosed NDRD superimposed DN. The rest of the patients were diagnosed isolated diabetic nephropathy; DN (40.6%). IgA nephropathy was either the most prevalent glomerular disease in NDRD (39.5%) and NDRD superimposed DN (34.0%). The second and third kidney biopsy findings in NDRD were lupus nephritis (18.7%), membranous nephropathy (12.5%), respectively. In NDRD superimposed DN, membranous nephropathy (18.0%), and ANCA associated vasculitis (14.0%) were the second and third pathological findings. The serum creatinine levels were higher in DN than in NDRD and NDRD superimposed DN (2.47 mg/dL, 1.25 mg/dL, and 1.63 mg/dL, respectively). Nephrotic syndrome was more common in NDRD superimposed DN, following DN and NDRD (38.0%, 37.3%, and 31.2%, respectively, p<0.05). Moreover, the quantity of proteinuria was found to be higher in DN and NDRD superimposed DN than in NDRD (4.0, 3.2, and 2.8 g/gCr, respectively, p<0.05).

Conclusion

This study disclosed the diversity and prevalence of NDRD that was diagnosed in almost 60% of DKD in Japanese diabetic patients. Presence of nephrotic syndrome was the more suggestive diagnosis of DN or NDRD superimposed DN. Kidney biopsy is the important means for the definite diagnosis and the proper treatment of glomerular disease in diabetic patients.