Heterogeneity of causes of proteinuria in patients with non-insulin dependent diabetes mellitus
Gordeev, A.V.; Peskov, D.I.
Terapevticheskii Arkhiv 73(6): 51-54
2001
ISSN/ISBN: 0040-3660 PMID: 11521524 Document Number: 537865
To make a retrospective clinicomorphological (autopsy) study of proteinuria causes. The records have been analysed for 231 patients with non-insulin-dependent diabetes mellitus (NIDDM) over 60 years of age who died in a general hospital between 1990 and 1999. The choice of patients with diabetic nephropathy (DN) for a further morphological investigation was based on the presence of proteinuria (> 0.5 g/day), normal renal function. 72 patients met the above criteria. Of them 26 were women. Proteinuria occurred more frequently in men (63.4%). A morphological examination of the kidneys revealed diabetic glomerulosclerosis (diffuse and focal) in 48(67%) patients. In 24(33%) patients proteinuria resulted from non-diabetic affection of the kidneys: amyloidosis, atherosclerotic and/or hypertensive nephroangiosclerosis, membraneous and myelomic nephropathy, mesangioproliferative glomerulonephritis. Glomerular changes were not registered in 4 patients. 35(72%) DN patients had diabetic retinopathy which was not found in patients with non-diabetic renal affection. Diabetic retinopathy in patients with NIDDM and proteinuria allows to conclude that the latter is consequent to DN. The absence of diabetic retinopathy in such patients promotes a search for other causes of proteinuria.