Kidney Week

Abstract: SA-PO0823

Histopathologic Patterns in Kidney Biopsies from Patients with Type 2 Diabetes at a Mexican Center

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

• Frías Frías, Roberto, Hospital de Especialidades Centro Medico Nacional Siglo XXI, Mexico City, CDMX, Mexico

Roberto Frías Frías, MD

• Pazos Perez, Fabiola, Hospital de Especialidades Centro Medico Nacional Siglo XXI, Mexico City, CDMX, Mexico

Fabiola Pazos Perez, MD, PhD

• Lopez Cabrera, Yessica, Hospital de Especialidades Centro Medico Nacional Siglo XXI, Mexico City, CDMX, Mexico

Yessica Lopez Cabrera, MD

Background

Renal involvement in type 2 diabetes mellitus (T2D) includes a wide spectrum of lesions, and the prevalence of non diabetic renal disease (NDRD) is often underestimated, particularly in Latin American populations. This study aimed to characterize clinical, biochemical, and histopathologic patterns in Mexican patients with T2D undergoing kidney biopsy.

Methods

We conducted a cross sectional, observational, retrospective analysis of adult patients with T2D who underwent native kidney biopsy at a tertiary referral center. Clinical data, laboratory parameters, and biopsy indications were obtained from medical records. Histopathologic evaluation included glomerular, tubulointerstitial, and vascular compartments. DN was classified according to international consensus criteria.

Results

Twenty-nine patients were included (mean age 55 years; 76.7% were male; median diabetes duration 14.5 years). Despite long standing T2D, glycemic control was relatively adequate (median HbA1c 6.7%). Notably, 53.3% had no diabetic retinopathy; among affected patients, non-proliferative retinopathy predominated. Median eGFR was 30.5 mL/min/1.73 m2, and proteinuria was in the nephrotic range (median 4.82 g/24 h). Active urinary sediment was frequent (hematuria 60%, leukocyturia 50%). Pure DN was found in 41.4%, isolated NDRD in 37.9%, and mixed lesions in 20.7%. Intermediate and advanced DN classes predominated. Tubulointerstitial injury was highly prevalent, with moderate to severe interstitial fibrosis and tubular atrophy in more than 70% of patients, along with frequent acute tubular necrosis and tubulointerstitial nephritis. Vascular lesions were consistent with chronic hypertensive and diabetic injury.

Conclusion

More than half of biopsied T2D patients exhibited NDRD or mixed lesions, highlighting the limitations of relying solely on clinical criteria. These findings support the use of kidney biopsy in T2D patients with atypical features and provide a basis for future prospective studies.