Author(s)

Manik Chandra Mondal^1*, Rana Mokarrom Hossain¹, K. B. M. Hadiuzzaman¹, Md. Omar Faroque¹, Shah Md. Zakir Hossain¹, A. K. M. Shahidur Rahman¹, Fahad Al Shatil Ashrafee¹, Popy Sarker², Abu Zafor Md. Salahuddin³, Mohammad Kamrul Ahsan⁴

¹Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.
²Department of Orthodontics and Dento-Facial Orthopaedics, Dhaka Dental College and Hospital (DDCH), Dhaka, Bangladesh.
³Department of Nephrology, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh.
⁴Holy Family Red Crescent Medical College Hospital (HFRCMCH), Dhaka, Bangladesh.

Background: Diabetes mellitus (DM) is the leading cause of end stage renal disease (ESRD) worldwide. Although DM with proteinuria is the ultimate result of diabetic nephropathy (DN), a wide spectrum of non-diabetic renal diseases (NDRD) can occur in such patients. Objective: To observe the frequency and histological pattern of NDRD in diabetic patients with proteinuria and to explore their association with clinical and laboratory parameters. Methods: This cross-sectional study was conducted in the Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from April 2016 to September 2017. In this study a total of 38 cases of DM with proteinuria (>1 gm/24-hour) were selected purposively. Renal biopsy was done in all patients. Based on histological findings they were categorized into two groups; Group 1 with NDRD and Group II with DN. Their clinical and laboratory parameters were analyzed and compared. Results: Among the total study subjects, 21 (55.3%) were male and 17 (44.7%) were female, mean (±SD) age 43.45 ± 9.99 years in the NDRD group and 41.57 ± 9.50 years in the DN group. Thirty one cases (81.6%) out of thirty eight had NDRD and seven (18.4%) cases had isolated DN; therefore more than two third cases had NDRD. Duration of DM was found to be significantly shorter (p = 0.004) in the NDRD group. Diabetic retinopathy was present in 12.9% cases in NDRD group vs. 57.1% cases in DN group (p = 0.025). Frequency of microscopic hematuria was significantly higher (90.3%) in NDRD patients (p = 0.002). Conclusion: The frequency of NDRD in type 2 diabetic patients other than diabetic nephropathy is relatively high. Membrano proliferative glomeru-lonephritis and membranous nephropathy are more common in NDRD. Absence of diabetic retinopathy, presence of hematuria and shorter duration of DM are markers associated with NDRD in type 2 DM, which are important indicators for renal biopsy in diabetic patients with proteinuria.

Diabetes Mellitus (DM), Diabetic Nephropathy (DN), Non-Diabetic Renal Disease (NDRD), Renal Biopsy

Mondal, M. , Hossain, R. , Hadiuzzaman, K. , Faroque, M. , Hossain, S. , Rahman, A. , Ashrafee, F. , Sarker, P. , Salahuddin, A. and Ahsan, M. (2019) Non-Diabetic Renal Disease in Patients with Type 2 Diabetes Mellitus with Proteinuria. Journal of Biosciences and Medicines, 7, 68-78. doi: 10.4236/jbm.2019.712007.