Diabetic nephropathy: Is it time yet for routine kidney biopsy?

dc.contributor.author

Gonzalez Suarez, Maria L

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Thomas, David B

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Barisoni, Laura

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Fornoni, Alessia

dc.date.accessioned

2021-02-01T19:18:50Z

dc.date.available

2021-02-01T19:18:50Z

dc.date.issued

2013-12

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2021-02-01T19:18:50Z

dc.description.abstract

Diabetic nephropathy (DN) is one of the most important long-term complications of diabetes. Patients with diabetes and chronic kidney disease have an increased risk of all-cause mortality, cardiovascular mortality, and kidney failure. The clinical diagnosis of DN depends on the detection of microalbuminuria. This usually occurs after the first five years from the onset of diabetes, and predictors of DN development and progression are being studied but are not yet implemented into clinical practice. Diagnostic tests are useful tools to recognize onset, progression and response to therapeutic interventions. Microalbuminuria is an indicator of DN, and it is considered the only noninvasive marker of early onset. However, up to now there is no diagnostic tool that can predict which patients will develop DN before any damage is present. Pathological renal injury is hard to predict only with clinical and laboratory findings. An accurate estimate of damage in DN can only be achieved by the histological analysis of tissue samples. At the present time, renal biopsy is indicated on patients with diabetes under the suspicion of the presence of nephropathies other than DN. Results from renal biopsies in patients with diabetes had made possible the classification of renal biopsies in three major groups associated with different prognostic features: diabetic nephropathy, non-diabetic renal disease (NDRD), and a superimposed non-diabetic condition on underlying diabetic nephropathy. In patients with type 2 diabetes with a higher degree of suspicion for NDRD, it is granted the need of a renal biopsy. It is important to identify and differentiate these pathologies at an early stage in order to prevent progression and potential complications. Therefore, a more extensive use of biopsy is advisable.

dc.identifier.issn

1948-9358

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1948-9358

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https://hdl.handle.net/10161/22309

dc.language

eng

dc.publisher

Baishideng Publishing Group Inc.

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World journal of diabetes

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10.4239/wjd.v4.i6.245

dc.subject

Diabetic nephropathy

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Kidney biopsy

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Non-diabetic renal disease

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Diabetic nephropathy: Is it time yet for routine kidney biopsy?

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Journal article

duke.contributor.orcid

Barisoni, Laura|0000-0003-0848-9683

pubs.begin-page

245

pubs.end-page

255

pubs.issue

6

pubs.organisational-group

School of Medicine

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Pathology

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Medicine, Nephrology

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Duke

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Clinical Science Departments

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Medicine

pubs.publication-status

Published

pubs.volume

4

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