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Renal biopsy in diabetic patients (experience of Nephrology Department of Clinic for Internal Diseases UCC Banjaluka)

By
Milorad Grujičić ,
Milorad Grujičić

Department of Nephrology of Clinic for Internal Diseases, University clinical center of Republika Srpska ,Banja Luka ,Bosnia and Herzegovina

Gordana Basta Jovanović ,
Gordana Basta Jovanović

Institut za patologiju, Klinički centar Srbije ,Belgrade ,Serbia

Aleksandra Salapura ,
Aleksandra Salapura

Clinic of Pathology, University clinical center of Republika Srpska ,Banja Luka ,Bosnia and Herzegovina

Vlastimir Vlatković ,
Vlastimir Vlatković

Clinic for Internal Medicine, Division of Nephrology, University clinical center of Republika Srpska ,Banja Luka ,Bosnia and Herzegovina

Dragan Vojvodić ,
Dragan Vojvodić

Department of Nephrology of Clinic for Internal Diseases, University clinical center of Republika Srpska ,Banja Luka ,Bosnia and Herzegovina

Abstract

Introduction. Apart from diabetic nephropathy diabetic patients may experience a nondiabetic kidney disease and the kidney biopsy is the best way to diagnose it. The aim of the study is to show the frequency und type of nondiabetic kidney disease diagnosed by kidney biopsy in diabetic patients.
Methods. We presented the results of renal biopsy in diabetic patients performed at the Department of Nephrology Clinic for Internal Medicine from April 2007 to May 2013. During the period nine biopsies in diabetic patients were performed (from the total of 157). The biopsy was performed with a biopsy gun- Gun Fast with 16G needle diameter, under control of ultrasound device (Toshiba Famio 5 with
probe guide). Two tissue samples were taken: one for optical microscopy and the other for immunofluorescence. The mean duration of diabetes was 4.9 years, in two men and seven women. One patient had retinopathy, whereas seven patients had hypertension.
Results. The indications for biopsy in our diabetic patients were: six patients with nephrotic syndrome, two with asymptomatic urinary abnormalities (persistent proteinuria and/or microhematuria), one patient with systemic lupus erythematosus. Six patients had a histological diagnosis of diabetic nephropathy, two patients had diabetic nephropathy combined with other disease (one combined with hypertensive
nephroangiosclerosis and the other with lupus nephritis), and one patient had primary membranous glomerulonephritis.
Conclusion. Renal biopsy in our nine patients with diabetes showed that three patients (33.3%) had nondiabetic kidney disease. In total, two out of three patients with nondiabetic kidney disease had glomerulal disease and one had vascular disease (hypertensive nephroangiosclerosis). Although fewer patients were considered in comparison to the studies of the other authors, our first experience shows a significant percentage of diabetic patients with nondiabetic kidney disease, which can only be diagnosed and confirmed by kidney biopsy.

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