Kidney Week

Abstract: FR-PO0336

Clinical Profile of Kidney Biopsies in Patients with Type 2 Diabetes and Role of Electron Microscopy

Session Information

• Diabetic Kidney Disease: Progression, Predictive Tools, Therapeutics, and Outcomes
  November 07, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Diabetic Kidney Disease

• 702 Diabetic Kidney Disease: Clinical

Authors

• Jaryal, Ajay, All India Institute of Medical Sciences Bilaspur, Bilaspur Shimla, HP, India

Ajay Jaryal, MBBS, MD

• Vikrant, Sanjay, All India Institute of Medical Sciences Bilaspur, Bilaspur Shimla, HP, India

Sanjay Vikrant, FASN

• Sharma, Alok, Dr Lal PathLabs Limited, Gurugram, HR, India

Alok Sharma, MD

Background

Renal involvement in diabetes mellitus (DM) is mostly due to diabetic nephropathy (DN) but can also be due to non-diabetic kidney disease (NDKD). To understand it we analyzed clinical profile of 32 kidney biopsies (KBX).

Methods

We did retrospective analysis of 32 KBX (2 years 2023-24) in adults with T2DM at a tertiary care teaching hospital in north India. There were no complications of KBX. Indications of KBX were: rapid or early onset of nephrotic syndrome (Group 1) and rapid or early decline of glomerular filtration rate (GFR) (Group 2).

Results

The mean age was 56.97 years (28-84), 68.75% were males & 46.87% required dialysis at presentation. The mean duration of DM was 76.75 vs 102.3 months (p 0.37), mean serum albumin 2.01 vs 2.82 mg/dl (p 1.08) and mean serum creatinine 1.3 vs 6.4 mg/dl (p < 0.001) in group 1 and 2 respectively. Mean duration of DM was higher in diabetic retinopathy (DRP) (138.75 vs 47.36 months p<0.001). Patients with NDKD were more likely to recover (Image 1). Complete renal recovery was seen in 6 patients: Membranous Glomerulonephritis-2, Minimal Change Disease-1, isolated acute interstitial nephritis (AIN) -2 and IgA Nephropathy-1. Patient with complete recovery had lesser duration of DM (28.5 vs 107.54 months p 0.036) and lacked DRP. 2/15 (both AIN) patients with need of HD recovered completely and rest progressed to ESRD. Mean podocyte effacement on electron microscopy (EM) was 100% in primary podocytopathy vs 42.85% in DN (Image 2).

Conclusion

2/3^rd of patients had diagnosis other than DN and commonest was AIN. EM helps in differentiating primary podocytopathy from diabetic podocytopathy. Patients with NDKD are more likely to recover completely underscoring the therapeutic implications of indication-based KBX in DM.

Clinical characteristics & Biopsy findings.

EM: A) Diffuse effacement (B) focal effacement of podocytes & thickened GBM.

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025xs1v4bkq