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Kidney Week

Abstract: PO0781

Biopsy Results in a Diverse Diabetic Cohort

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Authors

  • Farrell, Douglas R., Icahn School of Medicine at Mount Sinai Department of Medicine, New York, New York, United States
  • Saha, Aparna, Icahn School of Medicine at Mount Sinai Department of Medicine, New York, New York, United States
  • Tokita, Joji E., Icahn School of Medicine at Mount Sinai Department of Medicine, New York, New York, United States
  • Sharma, Shuchita, Icahn School of Medicine at Mount Sinai Department of Medicine, New York, New York, United States
  • Chan, Lili, Icahn School of Medicine at Mount Sinai Department of Medicine, New York, New York, United States
Background

Diabetes is the most common cause of kidney failure in the US. However, many of these patients never receive a biopsy, and therefore diabetic nephropathy (DN) is presumed based on clinical features. Therefore, we sought to determine the prevalence and outcomes of non-diabetic renal disease (NDRD) in a diverse cohort of diabetic patients referred for biopsy.

Methods

Patients were included if they had a biopsy performed at The Mount Sinai Hospital from 2018-2019, and if they had a hemoglobin A1c > 6.5% or diabetes was mentioned in their past medical history. Charts were excluded if no data existed after biopsy, dialysis-dependence occurred prior to biopsy, and if insufficient amounts of glomeruli were observed. Baseline characteristics including age, gender, race/ethnicity, blood pressure, creatinine, and urine protein/creatinine ratio (UPCR) were recorded. Outcomes measured were 1 year UPCR, 1 year creatinine, need for dialysis, and death.

Results

In total, 81 charts were included for analysis, of which 21 biopsies had DN alone, 26 had DN + NDRD, and 27 had NDRD alone (Figure 1A). In patients with NDRD, a broad range of pathology was seen (Figure 1B). There were no significant differences in characteristics of patients with DN alone and any NDRD (Figure 1C). There was a non-statistically significant difference in median one year creatinine and one year UPCR between patients with DN and NDRD (1.67 vs. 3.07 (p=0.1) and 2490 vs. 3540 (p=0.2)). Additionally, there was a non-statistically significant difference in death and dialysis treatment between DN and NDRD patients, 4 (14%) vs. 3 (6%) (p=0.2) and 5 patients (18%) vs. 19 (36%) (p=0.09), respectively. DN had lower odds of requiring dialysis at 1 year from biopsy OR 0.39 (95% CI 0.13-1.19).

Conclusion

In our selected diverse population of diabetic patients with kidney biopsies, the majority of patients had NDRD on pathology. While not statistically significant, DN patients had lower follow up creatinine and UPCR, and less patients on dialysis at 1 year.