Abstract: SA-PO0832
Spectrum of Nondiabetic Kidney Disease in Patients with Biopsy-Proven Diabetic Nephropathy: A 10-Year Single-Center Study
Session Information
- Glomerular Diseases: Management, Evolving Strategies, and Practice-Changing Advances
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- El-Bizri, Raina, Brown University, Providence, Rhode Island, United States
- Patel, Pooja V., Brown University, Providence, Rhode Island, United States
- Nizami, Tarek, Brown University, Providence, Rhode Island, United States
- Raker, Christina A., Brown University, Providence, Rhode Island, United States
- Omara, AnnMarie, Brown University, Providence, Rhode Island, United States
- Shah, Ankur, Brown University, Providence, Rhode Island, United States
- Merhi, Basma Omar, Brown University, Providence, Rhode Island, United States
Background
Diabetic nephropathy (DN) is often presumed to be the primary cause of kidney disease in patients with diabetes and chronic kidney disease, though the prevalence of concurrent non-diabetic kidney disease (NDKD) remains unclear. We evaluated the frequency and clinical correlates of NDKD on native kidney biopsy.
Methods
We performed a retrospective review of adult patients undergoing native percutaneous renal biopsy at Rhode Island Hospital between 2015 and 2025. Histopathologic diagnoses were categorized as isolated DN or concurrent NDKD. Clinical and laboratory variables were compared between groups using Fisher’s exact and Wilcoxon rank-sum tests.
Results
A total of 829 biopsies were performed on 778 patients. 140 biopsies with DN were identified. Of these, 25 (17.9%) demonstrated isolated DN, while 115 (82.1%) showed concurrent NDKD.
Patients with concurrent NDKD were older (median age 63 vs. 52 years, p=0.005) and more likely to be male (64.4% vs. 40.0%, p=0.04) compared with those with isolated DN. Serum creatinine at biopsy was higher among patients with concurrent NDKD (3.08 mg/dL [IQR, 1.67–5.65] vs. 1.94 mg/dL [IQR, 1.56–2.74], p=0.02). HbA1c, urine protein-to-creatinine ratio (UPCR), and urine albumin-to-creatinine ratio (UACR) did not differ significantly between groups (Table 1). Severe hematuria (3+ blood) was observed in patients with concurrent NDKD (17.9% vs. 0%), although the overall distribution of hematuria severity was not significantly different between groups (p=0.14).
The most common NDKD findings were acute tubular injury (46.1%), focal segmental glomerulosclerosis (42.6%), chronic kidney disease-related changes (35.7%), IgA nephropathy (13.0%), acute interstitial nephritis (11.3%), and thrombotic microangiopathy (7.8%).
Conclusion
Concurrent non-diabetic kidney disease was frequently identified in patients with biopsy-proven diabetic nephropathy, highlighting the heterogeneity of kidney disease in diabetes. These findings underscore the value of kidney biopsy in diabetic patients in characterizing complex kidney disease in diabetes.