2021, Vol. 3, Issue 2, Part D

Methodology: Single centre based prospective observational study carried out during the period from M a y 2016 to September 2019. Type 2 DM patients with atypical clinical renal disease who underwent renal biopsy to rule out NDRD at King George Hospital, Visakhapatnam were included in the study.

Results: In the present study, the overall prevalence of NDRD with or without underlying DN in our study was 71.7%. The prevalence rates of isolated NDRD, NDRD with DN and isolated DN were 51.2%, 20.5%, and 28.2% respectively. Shorter duration of diabetes, absence of retinopathy, presence of active urine sediment are markers associated with NDRD in type 2 diabetics and are strong indicators for biopsy. Isolated DN group patients suffer significantly with hypertension compared to NDRD group. Isolated NDRD group patients had low HbA1c (<7%) values compared to isolated DN group. The most common clinical presentations are RPRF, AKI and acute deterioration in renal function. The common lesion found in NDRD patients with or without underlying DN was acute tubulointerstitial nephritis. In Isolated NDRD group, primary glomerular diseases were most common. IgA Nephropathy was the most common glomerular disease in our study.

Conclusion: To conclude, it is difficult to differentiate NDRD from DN merely on the basis of clinical and laboratory criteria and kidney biopsy is an important diagnostic tool to define underlying disease and to identify the treatable causes.