Abstract: TH-PO0874
Not All That Glitters Is Diabetes: When Diabetes Glomerulopathy Was Not the Only Answer, a Case Series
Session Information
- Glomerular Case Reports: Potpourri
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Aldana Barrientos, Evelyn C., Southwest healthcare Medical Education Consortium, Temecula, California, United States
- Sauceda, Oscar, Centro del rinon, diabetes y transplante renal, San Pedro Sula, Honduras
Introduction
Diabetic nephropathy is the leading cause of End-stage renal disease worldwide, accounting for up to 40% of all dialysis patients. As a result, clinicians often attribute proteinuria in diabetic patients to diabetic nephropathy sometimes without further investigation, however several studies have shown that around 60% of diabetic patients have nondiabetic nephropathy. Despite this information, the amount of kidney biopsies in diabetic patients remain low. This case series includes three non-controlled diabetic patients whose diagnoses were not just diabetes, ranging from immune complex glomerulopathy to amyloidosis. These cases emphasize the critical need to consider renal biopsy before it is too late to change the outcome in atypical patients.
Case Description
67 y/o male with HTN, DM for >10 years and Non-Hodgkin’s Lymphoma on remission for the past 2 years. Consulted for Anemia and elevated Creatinine. Medications Valsartan, empagliflozin, Sitagliptin/Metformin, Nifedipine. Hb 9.2, Creatinine 5.3, A1c 9.3,GFR 9, 3.9 gr/day of proteinuria. C4, C3, ANA, hep C, Hep B and HIV negative. Biopsy with Glomerulonephritis with membranoproliferative pattern due to immune complex.
62 y/o female with DM insulin dependent and HTN for the past 6 years. Consulted for anemia. Medications Olmesartan, NPH insulin Nifedipine, Hb 9.7, Creatinine1.9 , A1c 8.7. GFR 28, 3.7 gr/day of proteinuria, C4, C3, ANA, hep C, Hep B and HIV negative. Biopsy with Glomerular, interstitial and vascular amyloidosis. Diabetic nephropathy class IIB. Active tubule-interstitial nephritis with eosinophils.
56 y/o male with DM for the past 30 years, using insulin in the last 5 years that consulted for lower back pain. Medications: Valsartan + HCT, NPH insulin, Oxcarbazepine, Hb 7.6, creatinine 5.8, A1c 9.1. GFR 10, 11 gr/day of proteinuria, C4, C3, ANA, hep C, Hep B and HIV negative. Biopsy with glomerular and vascular amyloidosis. Diabetic mesangial sclerosis class III.
Discussion
These three different patients with poorly controlled diabetes showed that in some cases it is crucial to perform kidney biopsy since other pathologies could be contributing or causing kidney damage. Although diabetic nephropathy remains the leading cause of end-stage renal disease, it is often assumed without confirmation, which can lead to missed or delayed diagnoses.