Heterogeneity of Renal Pathology in Korean NIDDM Patients with Microalbuminuria

Chung, Yun Ey; Lee, Ki Up; Park, Joong Yeol; Hong, Sung Kwan; Kang, Jae Young; Lee, Jong Soo; Oh, Young Ha; Chung, Jaegul; Yu, Eunsil; Park, Jung Sik

Abstract

OBJECTIVE
It was suggested that the cause of microalbuminuria is heterogeneous in NIDDM. However, only a few studies are available that investigated the renal pathology in NIDDM patients with microalbuminuria. This study was undertaken to evaluate renal pathology in Korean NIDDM patients with microalbuminuria.
METHODS
Fifty NIDDM patients with microalbuminuria and without retinopathy were undertaken renal biopsy. Renal pathologic findings were classified as follows: group A, near-normal finding; group B, typical diabetic nephropathology; group C, atypical patterns of renal injury (mild glomerular change with disproportionally severe tubulointerstitial lesion, arteriolar hyalinosis or global glomerular sclerosis); group D, non-diabetic renal lesion.
RESULTS
Seventeen patients were classified into group A, 19 into group B and 8 into group C. Six patients had non-diabetic renal lesions and they were all confirmed to be IgA nephropathy. Fasting blood sugar and GFR were significantly higher in group B than in group A and group C respectively, and systolic blood pressure was higher in group C than in group A.
CONCLUSION
Renal pathology in microalbuminuric NIDDM patients without retinopathy was heterogeneous. This may explain heterogeneous clinical meaning of microalbuminuria in NIDDM.