Renal Biopsy in patientwith Diabetes Mellitus tipo 2. Case report

Abstract

Introduction: Chronic kidney disease in diabetic patients can present as diabetic kidney disease, non-diabetic kidney disease, or the coexistence of both. Objective: A case is reported of a diabetic patient with nephrotic syndrome and decreased renal function who performed a renal biopsy for suspected of non-diabetic kidney disease. Material and Methods: The data was collected from physical examination and clinical history. A renal biopsy was performed and was studied with optical microscopy and immunofluorescence techniques. Results: We report a 64-year-old, obese female patient with a history of insulin-dependent type 2 diabetes mellitus for 12 years and controlled arterial hypertension that began with edema in the lower limbs and foamy urine three months ago. The physical and laboratory examination revealed nephrotic syndrome and decreased renal function. A renal biopsy was performed and it was concluded aschronic kidney disease in stage 3a plus membranous glomerulopathy in stage II with moderate tubulointerstitial and vascular damage coexisting with diabetic kidney disease instage II. Conclusions: It is important to evaluate all diabetic patients with chronic kidney disease for the possibility of developing non-diabetic kidney disease. The result of the kidney biopsy could change the prognosis and treatment of the disease.