L SKEAT1, T SIU1, M MANTHA1, S DHEDA1
1Department of Nephrology, Cairns Base Hospital, Cairns, Queensland
Aim: To establish the prevalence and nature of non-diabetic renal disease in the renal biopsies of diabetics in North Queensland.
Background: Far North Queensland has a high prevalence of type 2 diabetes particularly within the Indigenous population. Diabetic nephropathy represents the bulk of chronic kidney disease (CKD) however to the knowledge of the authors no specific studies in this region have established the prevalence of non-diabetic renal disease in the diabetic population.
Methods: The hospital renal database was used to identify diabetics between 1993 and 2016 who underwent a renal biopsy. 173 patients were identified and case files were retrospectively reviewed. Patient were divided into 3 groups, Group I, isolated non-diabetic renal disease (NDKD); Group II, mixed disease; Group III, isolated diabetic glomerulosclerosis.
Results: 173 patients were included, 97 were male and 76 female. The main indications for renal biopsy were an unexplained accelerated decline in renal function or progressive proteinuria. In Group I (NDKD) there were 52 patients (30%). The most prevalent pathologies were IgA nephropathy (21%) and focal-segmental glomerulosclerosis (FSGS) (13%). 44 patients were in Group II (25%) with a combination of diabetic and non-diabetic pathology primarily FSGS (21%) and Immune Complex Glomerulonephritis (21%). The remaining 76 patients in group III (44%) had isolated diabetic glomerulosclerosis.
Conclusions: In comparison to many other Australian populations the prevalence of NDKD and mixed diabetic and non-diabetic pathology is lower in the North Queensland diabetic population undergoing biopsy, while the prevalence of isolated diabetic glomerulosclerosis is higher. These results have implications for clinical management of diabetic patient with CKD in the Far North Queensland region.