A predictive model of non-diabetic kidney disease in patients with diabetes mellitus and chronic kidney disease. A Spanish multi-center study

Abstract

Aims: Kidney biopsy is increasing in patients with diabetes and around 50-60% of patients with diabetes have non-diabetic kidney disease (NDKD). Identifying NDKD is crucial since these patients have a better renal prognosis and survival compared to patients with diabetic nephropathy (DN). The objective of this study is to provide a clinical practice tool for through a predictive model of NDKD.

Material and methods: Observational and multicenter Spanish study of the pathological results of kidney biopsies in patients with diabetes from 2002 to 2014. A logistic regression analysis and the probability of presenting NDKD was calculated using a punctuation score.

Results: A total of 832 patients with diabetes and renal biopsy were analyzed. An accurate risk-predictive model for NDKD was developed with five top-ranked non-invasive clinical variables (age, serum creatinine, presence of diabetic retinopathy, microhematuria and peripheral vascular disease) obtaining a score for each one allowing for a proper prediction of NDKD.

Conclusions: In our study, we developed a risk-stratification score to calculate the probability of NDKD. This could be in a next future a useful tool for the clinical indication of renal biopsy in patients with diabetes and kidney disease.

Keywords: Biopsia renal; Chronic kidney disease; Diabetes mellitus; Enfermedad renal crónica; Enfermedad renal no diabética; Kidney biopsy; Non-diabetic kidney disease.