ABSTRACT
Background of the Study, Aims
and Objectives: There are very few studies
on histological patterns of diabetic nephropathy in our part of country. The aim of this study
was to evaluate the renal involvement in patients with Type-2 diabetes mellitus
(T2DM), assess the histopathological
changes and establish a clinico-pathological correlation. Subjects, Method
and Materials: Thirty two Type 2 DM
patients with nephropathy, after screening consecutive hundred(100) Type 2
Diabetics admitted to the Medicine Department were evaluated for renal
involvement by kidney biopsy and
histopathological study. Statistical analysis was done by student’s t-test, chi-square and linear
regression analysis. Results: Thirty two patients (32) with diabetic
nephropathy (20 males and 12 females) formed the study group out of hundred
(100) consecutive Type-2 diabetes mellitus patients (58 males and 42 females) admitted to Medicine
Department of SCB Medical College Hospital, Cuttack. The frequency of occurrence of clinical diabetic
nephropathy was 32%. Most of the patients were having duration of DM of 6-10 years (87.5%). Pedal edema was found
in 96.87%, hypertension in 87.5%
patients respectively. Regression analysis showed that durations of DM and HbA1c were
the two significant risk factors (P < 0.05) for development of nephropathy. Histopathologically,
diffuse glomerulosclerosis was the most common form of renal abnormality found
in 93.75% followed by nodular glomerulosclerosis in 62.50% with overlap in many
patients, membranous nephropathy
in 12.5% and focal necrotising glomerulonephritis in 6.25% respectively. There was no
statistically significant clinicopathological correlation observed between
clinical and biochemical parameters in patients harbouring the two predominant
histological types of nephropathy i.e. diffuse and nodular glomerulosclerosis with respect to age, sex, duration of
diabetes, body mass index, systolic blood pressure, HbA1c, 24 hour urinary
protein, creatinine clearance, serum urea, serum creatinine or lipid profile. Conclusion: Durations of diabetes and HbA1c
were found to be strongly associated with development of diabetic nephropathy.
Diffuse glomerulosclerosis was the most common form of renal abnormality found
in 93.75% followed by nodular glomerulosclerosis in 62.50% of patients.