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Association between kidney biopsy findings in CKD patients with diabetes and renal replacement therapy initiation, a perspective from a low-middle income country

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Abstract

Kidney disease in diabetes mellitus is usually explained by diabetic kidney disease, but other superimposed etiologies occur frequently. The distinction between diabetic kidney disease and non-diabetic kidney disease can only be made by performing kidney biopsy. Our objective was to evaluate the association of diabetic kidney disease, non-diabetic kidney disease, or both with renal replacement therapy initiation. This is a retrospective cohort that included patients with type 2 diabetes mellitus for whom a kidney biopsy was indicated. Subjects were followed-up for 5 years, until renal replacement therapy initiation or were lost to follow up. One hundred and forty-one patients were included, 53 (39%) had diabetic kidney disease, 13 (9%) had non-diabetic kidney disease and 75 (54%) had both. Ninety-four percent of the cohort initiated renal replacement therapy during the 5-year follow-up. Higher degree of fibrosis was associated with a trend towards higher risk of requiring renal replacement therapy. In addition, the combined diabetic kidney disease + non-diabetic kidney disease group was associated with higher need of renal replacement therapy initiation when compared to the diabetic kidney disease group.

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Fig. 1

Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

CKD:

Chronic kidney disease

DM:

Diabetes mellitus

DKD:

Diabetic kidney disease

eGFR:

Estimated glomerular filtration rate

FSGS:

Focal and segmental glomerulosclerosis

NDKD:

Non-diabetic kidney disease

T2D:

Type 2 diabetes

RRT:

Renal replacement therapy

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Acknowledgements

This work was presented in abstract form at the American Society of Nephrology Meeting 2020.

Funding

The research was funded by the nephrology division of the Instituto Nacional de Cardiología. The funding body had no role in the design of the study and collection, analyses, and interpretation of data and in writing the manuscript.

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Authors and Affiliations

  1. Division of Nephrology, Instituto Nacional de Cardiología Ignacio Chávez, Juan Badiano No. 1, Col. Sección XVI, Delegación Tlalpan, 14080, Mexico City, Mexico

    Enzo Vásquez-Jiménez, Ana Lucía Diez de Solano Basilla & Magdalena Madero

  2. Division of Nephrology, Juarez Hospital of Mexico, Mexico City, Mexico

    Enzo Vásquez-Jiménez

  3. Research Center of Infectious Diseases, National Institute of Respiratory Diseases “Ismael Cosío Villegas”, Mexico City, Mexico

    Iván Armando Osuna-Padilla

  4. Division of Pathology, National Institute of Cardiology “Ignacio Chavez”, Mexico City, Mexico

    Virgilia Soto-Abraham

  5. Pathology Department, General Hospital of Mexico, Eduardo Liceaga, Mexico City, Mexico

    Virgilia Soto-Abraham

Authors
  1. Enzo Vásquez-Jiménez
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  2. Ana Lucía Diez de Solano Basilla
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  3. Iván Armando Osuna-Padilla
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  4. Virgilia Soto-Abraham
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  5. Magdalena Madero
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Contributions

EV, AD, MM were involved in the design, interpretation of results and writing of the manuscript. VS was the pathologist interpreting the biopsies, IO was involved with the statistical analysis, interpretation of results and writing of the manuscript. Authors’ approval: All authors have read and approved the manuscript in its current state.

Corresponding author

Correspondence to Magdalena Madero.

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Conflict of interest

MM: Advisory Board: Bayer, Astra Zeneca, Boehringer.

Ethics approval and consent to participate

Data analysis was retrospective and written informed consent was obtained from all participants at the time of biopsy. This study was conducted in compliance with the Declaration of Helsinki.

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Not applicable.

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Vásquez-Jiménez, E., de Solano Basilla, A.L.D., Osuna-Padilla, I.A. et al. Association between kidney biopsy findings in CKD patients with diabetes and renal replacement therapy initiation, a perspective from a low-middle income country. J Nephrol 35, 2373–2375 (2022). https://doi.org/10.1007/s40620-022-01394-x

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  • DOI: https://doi.org/10.1007/s40620-022-01394-x

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