SP431RENAL BIOPSY FINDINGS IN PATIENTS WITH DIABETES MELLITUS IN SCOTLAND: A MULTI-CENTRE RETROSPECTIVE STUDY

Abstract

INTRODUCTION AND AIMS: Diabetes mellitus (DM) is the leading cause of endstage kidney disease (ESKD) requiring renal replacement therapy. The utility of renal biopsy in patients with diabetes mellitus is controversial. Renal biopsy findings inDM can be divided into: diabetic nephropathy (DN), non-diabetic renal disease (NDRD), or mixed DN+NDRD. Timely identification of patients with NDRD is important to provide appropriate therapeutic measures. This study aimed at identifying the frequency and the pathology spectrum of renal disease in diabetic patients who underwent kidney biopsy in 3 renal units in Scotland. METHODS: we conducted a retrospective observational study of clinical-pathologic findings in all patients with diabetes mellitus who underwent renal biopsy between January 2010 and December 2016 in 3 renal units (Aberdeen, Inverness and Greater Glasgow). Data were gathered from electronic patient record systems. Logistic regression analysis was performed to identify predictors of NDRD. RESULTS: 247 patients were included: 150 men (60.7%), 217 type 2 DM(87.9%), mean age 62.1 years, and mean serum creatinine at the time of renal biopsy of 261 mmol/L (+/-190 std). On biopsy, 92 patients (37.2%) had DN, while 127 (51.4%) had NDRD and 28(11.4%) had NDRD superimposed on DN. The commonest NDRD aetiologies were IgA nephropathy (18.7%), tubulointerstitial nephrtis (16.8%) and idiopathic membranous nephropathy (10.3%). Predictors of NDRD were age (OR 1.027, 95% CI 1.002-1.052, p=0.03), duration ofDM(OR 0.94, 95% CI 0.900-0.987, p=0.01) and absence of AKI as indication for biopsy (OR 0.22, 95% CI 0.059-0.826, p=0.025). There were no significant differences in renal or patient survival between DN and NDRD groups. CONCLUSIONS: The majority of renal biopsies carried out in patients withDM revealed a NDRD. In this study, age at the time of biopsy, duration ofDMand AKI were the main pointers towards NDRD. Renal and patient survival were not significantly different between DN and NDRD groups.