Histological evidence of diabetic kidney disease precede clinical diagnosis

Giorgia Comai, Deborah Malvi, Andrea Angeletti, Francesco Vasuri, Sabrina Valente, Francesca Ambrosi, Irene Capelli, Matteo Ravaioli, Gianandrea Pasquinelli, Antonietta D'Errico, Alessia Fornoni, Gaetano La Manna

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background: In the absence of a histological diagnosis, persistent albuminuria is globally accepted as the main diagnostic criteria for diabetic kidney disease (DKD). Methods: In the present retrospective study, we evaluated data from an Italian cohort of 42 deceased diabetic donors (mainly with type 2 diabetes). Using the kidney biopsies obtained at the time of donation to evaluate single or double allocation based on Karpinski score, we determined the prevalence of histological lesions attributable to diabetes. Results: All 42 donors presented with proteinuria in the normal range and an estimated glomerular filtration rate (eGFR) (chronic kidney disease [CKD]-EPI) >60 mL/min/1.73 m2. A kidney biopsy was available for 36 patients; of these, one was not interpretable and 32 showed histopathological lesions consistent with DKD and encompassing all histological classes. Thus, we found a relatively high proportion of histologically proven DKD that had been clinically undiagnosed, as none of the patient had significant proteinuria and eGFR <60 mL/min/1.73 m2. Conclusions: The data we present here support the need to implement routine kidney biopsies in normoalbuminuric diabetic subjects in the early stages of CKD. Such strategy may help to improve risk stratification in diabetic patients and guide therapeutic decisions during the early stages of the disease.

Original languageEnglish (US)
Pages (from-to)29-36
Number of pages8
JournalAmerican Journal of Nephrology
Issue number1
StatePublished - Jul 1 2019


  • Albuminuria diabetes mellitus
  • Diabetic kidney disease
  • Diabetic nephropathy
  • Kidney biopsy

ASJC Scopus subject areas

  • Nephrology


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