Abstract: SA-PO296
Utility of Kidney Biopsy in Patients with Diabetic Nephropathy: A Retrospective Study of 13,995 Cases
Session Information
- Diabetic Kidney Disease: Clinical Pathology, Diagnostic and Treatment Advances
October 26, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Diabetic Kidney Disease
- 702 Diabetic Kidney Disease: Clinical
Authors
- Caza, Tiffany, Arkana Laboratories, Little Rock, Arkansas, United States
- Charu, Vivek, Stanford University School of Medicine, Stanford, California, United States
- Dai, Dao-Fu, Johns Hopkins Medicine, Baltimore, Maryland, United States
- Davis, Vicki Grey, Statistical Consultant, Afton, Virginia, United States
- Walker, Patrick D., Arkana Laboratories, Little Rock, Arkansas, United States
Background
The number of renal biopsies performed in patients with diabetes has increased rapidly in the last twenty years. The value of the biopsy has been questioned because of the reported variability of finding a non-diabetic kidney disease (NDKD). We sought to determine the percentage of patients with a NDKD or diabetic nephropathy (DN) alone and to determine clinical indications, demographic factors, and histologic parameters that increase the odds of finding a NDKD on kidney biopsy.
Methods
A retrospective analysis of clinical and pathologic parameters from patients with DN received from 2001 through 2022 at Arkana Laboratories was performed. Inclusion criteria included a diagnosis of DN, available clinical information, and an adequate biopsy with ≥10 glomeruli.
Results
A total of 13,995 patients with DN were identified. A second diagnosis of a NDKD was identified in 27.1%. Of the 55 different NDKD diagnoses, acute tubular injury and infection-associated glomerulonephritis accounted for almost 50%. Acute kidney injury and acute nephritic syndrome had greater odds of a second diagnosis (Figure 1). The youngest (≤30 years) and oldest (≥60 years) patients had a higher prevalence of a second diagnosis. Higher chronicity indices on biopsy were associated with a lower prevalence of a second diagnosis.
Conclusion
Patient age and clinical indication for biopsy influences the odds of finding a NDKD on biopsy. Given the wide array of NDKDs found (55 diagnoses in total), the renal biopsy remains a critical tool in the care of diabetic patients.
Odds of a second diagnosis by clinical indication. Odds ratios (OR) and 95% confidence intervals (95% CI) for a second diagnosis are presented by clinical indication for N=13,995 renal biopsies with a diagnosis of diabetic nephropathy. ORs >1 (<1) imply a higher (lower) probability of a second diagnosis for patients presenting with that clinical indication versus patients with a different indication.