Andrew Deepak, Rajiv (2014) Concordance between Diabetic Nephropathy and Retinopathy in Type 2 Diabetes Mellitus. Masters thesis, Madras Medical College, Chennai.
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Abstract
INTRODUCTION : Diabetic nephropathy and retinopathy are two frequent complications of diabetes mellitus.1They add to the burden of chronic kidney disease and blindness respectively.1 These microvascular complications are related to the duration of diabetes, poor sugar control and hypertension . Diabetic nephropathy is a syndrome comprising of persistent proteinuria, hypertension,a low glomerular filtration rate (GFR). Retinopathy is an important cause of loss of vision in those less than 65 years. Thirty to 40 % of all type 2 diabetics develop proteinuria. Persistant proteinuria is characteristic of diabetic nephropathy which also requires the following criteria to be fulfilled, which are presence of diabetic retinopathy and absence of any other kidney disease except for diabetic glomerulosclerosis.2 A proteinuric type 2 diabetic can develop other glomerular diseases as well .3The presence of such non diabetic lesions in a proteinuric type 2 diabetic has been well documented .In one study as high as 30 % of the proteinuric diabetics had non diabetic kidney diseases. As a spectrum of non diabetic renal diseases can occur in a proteinuric type 2 diabetic patient ,the precise diagnosis of diabetic nephropathy requires histological evaluation by renal biopsy. While there is a strong concordance between diabetic nephropathy and retinopathy, in type 1 diabetes mellitus ,in type 2 diabetes the concordance is around 60 % as per studies done by Parving [et al] . Studies by J Prakash [et al.] showed diabetic retinopathy not to be a good predictor of diabetic nephropathy. In 50 % of those without retinopathy, nephropathy was noted. Non diabetic renal lesions alone or coexisting with DN were noted in 40 % of those with retinopathy . Hence we felt the need of a study to determine the concordance between diabetic nephropathy and retinopathy and to see the spectrum of non diabetic kidney diseases in proteinuric type 2 diabetics of our department . AIMS AND OBJECTIVES : To study the concordance between diabetic nephropathy and retinopathy in patients of type 2 diabetes mellitus. To study the clinical and lab profile of a patient with diabetic nephropathy Vs a patient with non diabetic nephropathy. The spectrum of non diabetic renal disease in a proteinuric type 2 diabetic . CONCLUSIONS : 1. The concordance between diabetic nephropathy and retinopathy was 53 % in our study. 2. There was no difference between the diabetic nephropathy and non diabetic nephropathy group in terms of duration of diabetes ,age, quantum of proteinuria, estimated GFR and hypertension. 3. The prevalence of non diabetic nephropathy was 34 % in our study. 4. Retinopathy was seen in 36 % of the non diabetic nephropathy group as well. 5. A renal biopsy is required for the accurate diagnosis of diabetic or non diabetic kidney disease in a proteinuric type 2 diabetic even in the presence of diabetic retinopathy.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Concordance ; Diabetic Nephropathy ; Retinopathy ; Type 2 Diabetes Mellitus. |
| Subjects: | MEDICAL > Nephrology |
| Depositing User: | Kambaraman B |
| Date Deposited: | 11 Jul 2017 05:28 |
| Last Modified: | 11 Jul 2017 05:28 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/1379 |
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