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GLOMERULONEPHRITIS IN TYPE 2 DIABETES MELLITUS

GLOMERULONEPHRITIS IN TYPE 2 DIABETES MELLITUS. MOHAN DAS M.K, JACOB GEORGE,VIMALA.A. DEPARTMENT OF NEPHROLOGY, MEDICAL COLLEGE, THIRUVANANTHAPURAM. 1. BACKGROUND. INCREASING INCIDENCE OF NON DIABETIC RENAL DISEASE AS A CAUSE OF ACUTE RENAL FAILURE IN TYPE 2 DIABETES MELLITUS.

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GLOMERULONEPHRITIS IN TYPE 2 DIABETES MELLITUS

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  1. GLOMERULONEPHRITIS IN TYPE 2 DIABETES MELLITUS MOHAN DAS M.K, JACOB GEORGE,VIMALA.A. DEPARTMENT OF NEPHROLOGY, MEDICAL COLLEGE, THIRUVANANTHAPURAM 1

  2. BACKGROUND • INCREASING INCIDENCE OF NON DIABETIC RENAL DISEASE AS A CAUSE OF ACUTE RENAL FAILURE IN TYPE 2 DIABETES MELLITUS. • SPECIFIC TREATMENT ALTERS OUTCOME. 2

  3. OBJECTIVES • INCIDENCE AND CLINICAL PROFILE OF NON DIABETIC RENAL DISEASE IN TYPE 2 DIABETES MELLITUS • RENAL HISTOLOGY • IDENTIFY NATURE OF GLOMERULAR DISEASE • PROGNOSTIC FACTORS • RESPONSE TO SPECIFIC TREATMENT 3

  4. PATIENTS&METHODS • PERIOD OF STUDY JUNE 1,2001-DEC 31,2004 INCLUSION CRITERIA • PATIENTS WITH TYPE 2 DIABETES MELLITUS AND ANY ONE OF THE FOLLOWING • ANTECEDENT INFECTION. • MICROSCOPIC OR MACROSCOPIC HAEMATURIA WITH NEGATIVE URINE CULTURE. • DISPROPORTIONATE DECLINE IN GFR. • .LOW C3. • ABSENCE OF DIABETIC RETINOPATHY. 4

  5. PATIENTS&METHODS(CONT.) • GFR IS CALCULATED USING COCKROFT AND GAULT FORMULA • DISPROPOTIONATE DECLINE IN GFR DEFINED AS DECREASE IN GFR MORE THAN 10ml/year 5

  6. EXCLUSION CRITERIA 1. PATIENTS WITH CARDIAC FAILURE. 2. PATIENTS WITH ISCHAEMIC NEPHROPATHY. 3. IDENTIFIED PRECIPITATING FACTORS FOR DETERIORATION OF GFR LIKE DRUGS, HYPOVOLEMIA. 6

  7. RESULTS • TOTAL NUMBER OF PATIENTS -24 • MEAN AGE OF PRESENTATION-51 • MALE TO FEMALE RATIO -13:11 • MEAN DURATION OF DIABETES-8yrs • MEAN DURATION OF HYPERTENSION-5yrs • MEAN BLOOD PRESSURE -150/100mmHg • ALL PATIENTS HAD NON NEPHROTIC RANGE PROTEINURIA WITH A MAXIMUM OF 2.8gms. 7

  8. CLINICAL PROFILE OF POST INFECTIOUS CRESCENTIC GN 35

  9. CLINICAL PROFILE OF POST INFECTIOUS CRESCENTIC GN 36

  10. CLINICAL PROFILE OF DPGN WITHOUT CRESCENTS 37

  11. CLINICAL PROFILE OF DPGN WITHOUT CRESCENTS 38

  12. CLINICAL PROFILE OF IgA 39

  13. CLINICAL PROFILE OF IgA 40

  14. CLINICAL PROFILE OF MGN, MPGN AND LN 41

  15. CLINICAL PROFILE OF MGN, MPGN AND LN 42

  16. CLINICAL PROFILE OF PATIENTS WITH DN ALONE 43

  17. CLINICAL PROFILE OF PATIENTS WITH TIN AND TIN+DN 44

  18. STATISTICAL ANALYSIS-GN IN TYPE 2 DM • Mean value for oliguria and pyoderma in survived group was 0.615 and 0.538 respectively and in expired group 1.00 and 1.00 • Standard error was 0.14 and 0.143 in survived group and 0.00 and 0.00 in expired group. • p-value was 0.018 and 0.008 in survived group and 0.02 and 0.008 in expired group • Statistically significant. 45

  19. GN IN TYPE 2 DIABETES MELLITUS 46

  20. GN IN TYPE 2 DIABETES MELLITUS 47

  21. STATISTICAL ANALYSIS - DPGN IN TYPE 2 DM • No variables are found to be statistically significant. • May be because of small sample size. 49

  22. DPGN IN TYPE 2 DM 50

  23. DPGN IN TYPE 2 DM 50

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