Non-Diabetic Kidney Disease Prevalent in Individuals With Type 2 Diabetes

In a recent single-center, cross-sectional study, researchers found a high prevalence of kidney disease in patients with type 2 diabetes that did not involve the patient’s diabetes diagnosis.

Despite previously published studies on the subject, the prevalence of diabetic kidney disease and non-diabetic kidney disease in adults with type 2 diabetes is still unclear.

In the current study, the authors set out to examine those with type 2 diabetes with renal involvement. The authors offered participants renal biopsies in an unselected manner prospectively to determine how many had diabetic kidney disease, non-diabetic kidney disease, and mixed kidney disease, which the researchers deemed those with both features of non-diabetic and diabetic kidney disease.

After screening 6247 individuals, a total of 869 people were included in the study. Individuals were aged 18 years or older and had type 2 diabetes. Of the 869 people, 818 were eligible for biopsy and 110 underwent renal biopsy. The researchers found that 66.4% had diabetic kidney disease (n = 73), 18.2% had non-diabetic kidney disease (n = 20), and 15.4% had mixed kidney disease (n = 17).

Based on these results, the authors concluded that the clinical or biochemical markers currently used to predict non-diabetic kidney disease still need improvement and are of limited value in terms of clinical decision making.

“[Non-diabetic kidney disease] is very common among subjects with [type 2 diabetes] and renal involvement,” the researchers concluded. “Currently used predictors to preselect biopsy for detecting [non-diabetic kidney disease] have limited value at making clinical decisions at the individual patient level.”

The researchers noted limitations in their study, which included the possibility of different results if the study was conducted at the community level and included all individuals with type 2 diabetes with renal involvement regardless of the stage of kidney disease. Further, the researchers only conducted biopsies on people who gave consent, which meant some people who may have been eligible for the biopsy did not undergo one.

Reference:

Basu M, Pulai S, Neogi S, et al. Prevalence of non-diabetic kidney disease and inability of clinical predictors to differentiate it from diabetic kidney disease: results from a prospectively performed renal biopsy study. BMJ Open Diabetes Res Care. Published online December 14, 2022. doi:10.1136/bmjdrc-2022-003058https://drc.bmj.com/content/10/6/e003058