INTRODUCTION AND AIMS: Renal biopsies performed in diabetic patients are increasing in number and complexity. The objective of the study is to determine the predictability of the diagnosis of a renal biopsy (diabetic nephropathy or non-diabetic nephropathy) (DN or NDN) using clinical and analytical data from patients with diabetes mellitus (DM).
METHODS: Multicenter retrospective descriptive study of the histological diagnosis of biopsies performed in 8 Spanish centers in diabetic patients between 2002 and 2014.
RESULTS: The cohort included 384 patients, 289 men (75%) with mean age of 62 ± 12.4 years with a mean duration of DM of 10 ± 7.7 years, creatinine 2.7 ± 1.9 mg / dl, MDRD-4 glomerular filtration rate of 36.9 ± 24.8 ml / min / 1.73 m2, glycosylated hemoglobin 7.7 ± 11.9%, baseline glycemia of 139.5 ± 60.8 mg / dl and proteinuria of 3.7 ± 12.1 g / 24h . (Table) The clinical indications for renal biopsy in 38% was nephrotic syndrome and/or rapid increase of proteinuria, 22% abrupt reduction of GF, 15% acute renal failure and 8% nephrotic proteinuria without diabetic retinopathy. Histological diagnosis of renal biopsy: 35% NND, 49% diabetic nephropathy and 16% ND + NND. Among biopsies with NDN lesions and diagnosis (51%), 6,5% had Nephroangiosclerosis, 3% had IgA nephropathy, 2,6% had Acute Interstitial Nephritis and 2.6% segmental and focal glomerulosclerosis.In patients with isolated NDN lesions and complete absence of DN, the three most frequent diagnoses were: Nephroangiosclerosis, IgA nephropathy and Acute Interstitial Nephritis. In the multivariate binary logistic regression analysis, the variables independently associated with NDN were: shorter duration of DM (HR: 0.997, 95% CI: 0.994-1, p = 0.04) and older age (HR: 04, 95% CI: 1.014-1.059, p = 0.001).
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