HISTOLOGICAL PATTERN OF NON-DIABETIC RENAL DISEASE IN TYPE 2 DIABETES MELLITUS. A STUDY IN A TERTIARY CARE HOSPITAL

ABSTRACT  OBJECTIVE: To determine the histological pattern of non-diabetic renal disease in type 2 diabetes mellitus. MATERIAL AND METHODS: This study was conducted in Nephrology department MTI Lady Reading Hospital Peshawar from January 2018 to January 2021. All type 2 diabetic patients with normal fundi were included in the study irrespective of time duration. Total of 30 patients were registered. Their bio data was entered in a prescribed proforma. Their fundoscopy was done. Those having normal fundi were included in the study and exposed to renal biopsy. Those patients having diabetic retinal changes were excluded from the study. RESULTS: Out of 30 patients, male were 20 and female were 10 with ratio of 2:1 with mean age of 55.5±13.3SD years. Pure diabetic nephropathy (DN) was noted in 9 (30%) cases, Non-Diabetic Renal Disease (NDRD) in 13 (43.3%) cases and NDRD on DN in 8 (26.7%) cases. Among the Non-Diabetic Renal Disease (NDRD), Membranous Glomerulonephritis (MGN) was present in 9 (30%) cases, Acute Tubular Necrosis (ATN) in 5 (16.6%) cases, Focal Segmental Glomerulosclerosis (FSGN) in 4 (13.33%.) cases, Mesangiocapillary Glomerulonephritis (MCGN) in 2 (6.7%) cases and Hemolytic Uremic Syndrome (HUS) in 1 (3.3%) cases. CONCLUSION: Early diagnosis of non-diabetic renal disease in type 2 diabetic patients benefits from early immunosuppressive therapy and prevent from CKD. Renal biopsy should be done in all patients with type 2 DM irrespective of time duration especially with normal fundi and atypical renal involvement. KEY WORDS: Renal biopsy, fundoscopy, non-diabetic renal disease, glomerulonephritis