Clinicopathologic Features Of Patients With Membranous Nephropathy Occurring With Type 2 Diabetes Mellitus

Objctive:The incidence of type 2 diabetes mellitus(T2DM)are increasing,and membranous nephropathy(MN)occurs with T2DM frequently.This study aims to investigate the clinicopathological features and outcome of such patients and to determine common clinical indicators of diabetic nephropathy(DN).Methodology:137 patients with biopsy-proven idiopathic membranous nephropathy(IMN)and T2DM were enrolled in this retrospective study.Another 100 IMN patients without DM were used as a control group.The clinicopathological features,treatment response and outcome were analyzed and compared between groups.Results:Isolated membranous nephropathy(D group)was found in 86 patients and MN superimposed on DN(DN group)in 51 patients.The mean age at renal biopsy(54.3319.52 years vs 40.43± 14.28 years,P=0.000;55.82±9.94 years vs 40.43±14.28 years,P=0.002)and the rate of hypertension(68.60%vs 19.00%,P=0.000;62.75%vs 19.00%,P=0.000)were higher than those in the control group.In multivariate analysis male(OR 2.887,95%CI=1.244-6.702),duration of diabetes(OR 1.009,95%CI=1.001?1.016),and diabetic retinopathy(OR 2.862,95%CI=1.219-6.721)were independent predictors of DN.The lesions of global glomerulosclerosis,interstitial fibrosis/tubular atrophy(IFTA)and afferent arterial in diabetic MN were more severe.There was no difference in the rates of complete remission(CR)between D group and control group(33.33%vs 45.45%,P=0.526).Conclusion:Diabetic MN usually presents with aging and hypertension clinically and with,severe global glomerulosclerosis,IFTA and afferent arterial lesions histologically.Male,duration of diabetes,and diabetic retinopathy may serve as indicators of DN.