Correlation of Demographic and Biochemical Features with Histological Classification of Diabetic Nephropathy

Abstract

Background: Diabetic Nephropathy (DN) is a renal disease that leads to progressive renal failure across the world and it is among the most challenging of all renal diseases. The categorization of DN is centered on the lesions of glomeruli and exhibits varied morphological features. These patients outcome is also affected by evaluating the lesions of tubules, interstitium and renal vessels. Objective: The objective of this study was to apply the current pathological categorization of DN by Tervaert et al to evaluate the lesions of kidney in DN and to correlate clinical and histopathological features. Methods: This was a retrospective study of 10 years' duration from 2010-2019 at the Histopathology Department, Chughtai Institute of Pathology, Lahore. Fifty two cases of DN were included in the study. Parameters which were assessed included age, gender, duration of diabetes, 24 hours' urinary proteinuria, serum creatinine, histologic classes of diabetic nephropathy, Interstitial inflammation Score, interstitial fibrosis & tubular Atrophy (IFTA) score, Arteriolar Hyalinosis (AH) score and large vessel arteriolosclerosis. Results: Out of 52 cases, 28 were males and 24 were females. Mean age of patients was 51.40 years. Mean duration of diabetes was 11.54 years. Mean serum creatinine level was 5.42 mg/dl. Mean proteinuria was 4.72 g/24 hours. The most frequent glomerular lesions were in Class III comprising 48% of all classes. Conclusion: There was a significant correlation of glomerular classes with serum creatinine levels and also with proteinuria. There was also correlation of IFTA with rising serum levels of creatinine and proteinuria.