Evidence map›Paper›PMID 41795127›Full record

ArticleJournal of diabetes investigation2026

Clinical significance of renal histological diagnosis in patients with type 2 diabetes and proteinuria atypical for diabetic nephropathy.

Shogo Kuwagata, Masami Chin-Kanasaki, Aki Yamada, Tomonori Sakae, Nahomi Ishimoto, Yoshimi Imamura-Uehara, Kosuke Yamahara, Mako Yasuda-Yamahara, Sho Sugahara, Yuki Tanaka-Sasaki and 7 more

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Article in Journal of diabetes investigation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

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17 authors.

Shogo KuwagataDepartment of Diabetes, Endocrinology & Nephrology, Shiga University of Medical Science, Otsu, Japan.
Masami Chin-KanasakiDepartment of Diabetes, Endocrinology & Nephrology, Shiga University of Medical Science, Otsu, Japan.
Aki YamadaDepartment of Diabetes, Endocrinology & Nephrology, Shiga University of Medical Science, Otsu, Japan.
Tomonori SakaeDepartment of Diabetes, Endocrinology & Nephrology, Shiga University of Medical Science, Otsu, Japan.
Nahomi IshimotoDepartment of Diabetes, Endocrinology & Nephrology, Shiga University of Medical Science, Otsu, Japan.
Yoshimi Imamura-UeharaDepartment of Diabetes, Endocrinology & Nephrology, Shiga University of Medical Science, Otsu, Japan.
Kosuke YamaharaDepartment of Diabetes, Endocrinology & Nephrology, Shiga University of Medical Science, Otsu, Japan.
Mako Yasuda-YamaharaDepartment of Diabetes, Endocrinology & Nephrology, Shiga University of Medical Science, Otsu, Japan.
Sho SugaharaDepartment of Diabetes, Endocrinology & Nephrology, Shiga University of Medical Science, Otsu, Japan.
Yuki Tanaka-SasakiDepartment of Diabetes, Endocrinology & Nephrology, Shiga University of Medical Science, Otsu, Japan.
Natsumi KuwataDepartment of Diabetes, Endocrinology & Nephrology, Shiga University of Medical Science, Otsu, Japan.
Kimihiro NishimuraDepartment of Diabetes, Endocrinology & Nephrology, Shiga University of Medical Science, Otsu, Japan.
Koichiro MurataDepartment of Diabetes, Endocrinology & Nephrology, Shiga University of Medical Science, Otsu, Japan.
Itsuko MiyazawaDepartment of Diabetes, Endocrinology & Nephrology, Shiga University of Medical Science, Otsu, Japan.
Shogo IdaDepartment of Diabetes, Endocrinology & Nephrology, Shiga University of Medical Science, Otsu, Japan.ORCID https://orcid.org/0000-0003-3165-3867
Natsuko OhashiDepartment of Diabetes, Endocrinology & Nephrology, Shiga University of Medical Science, Otsu, Japan.
Shinji KumeDepartment of Diabetes, Endocrinology & Nephrology, Shiga University of Medical Science, Otsu, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

aimMost patients with proteinuria are considered to have typical diabetic nephropathy (DN). However, when proteinuria occurs without diabetic retinopathy, with hematuria, or persists despite strict glycemic and blood pressure control, it is considered atypical for DN and warrants further evaluation for non-DN via kidney biopsy. Nevertheless, comprehensive information on renal histopathology and prognosis following kidney biopsy remains limited. This study aimed to clarify these issues through a retrospective analysis.

methodsAmong 490 patients who underwent kidney biopsy at Shiga University of Medical Science Hospital between 2013 and 2024, 51 Japanese patients with type 2 diabetes who met at least one criterion for proteinuria atypical for DN were included. Pre- and post-biopsy changes in proteinuria levels and eGFR decline rate, as well as renal histology, were analyzed.

resultsAmong the 51 patients, 17 (33.3%) were histologically diagnosed with typical DN, whereas 34 (66.7%) were diagnosed with non-DN, including membranous nephropathy, immunoglobulin A (IgA) nephropathy, renal sclerosis, interstitial nephritis, vasculitis, and others. Compared with the DN group, patients with non-DN were significantly older and had a lower prevalence of diabetic retinopathy. Additionally, the non-DN group showed significant improvements in both proteinuria levels and in the eGFR decline following biopsy and appropriate disease-specific therapy.

conclusionA kidney biopsy identified a wide range of kidney diseases as the underlying causes of atypical proteinuria in DN, particularly in elderly patients, thereby improving renal outcomes. These findings underscore the clinical importance of heightened awareness of atypical proteinuria in diabetes management, particularly in aging populations.

Indexed as

Diabetes Mellitus, Type 2Diabetic NephropathiesKidneyProteinuriaAgedBiopsyFemaleGlomerular Filtration RateHumansMaleMiddle AgedPrognosisRetrospective Studiesdiabetic nephropathynon‐diabetic nephropathyproteinuria

Identifiers

PMID41795127
PMCPMC13137274

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