THE HIDDEN BURDEN OF DIABETIC NEPHROPATHY: EVIDENCE FROM AN AUTOPSY-BASED ANALYSIS

Aim- To analyse the number of patients with Diabetic Nephropathy at autopsy and classify cases of Diabetic Nephropathy based on histological findings. Materials and Methods- A total number of 2524 autopsy cases (age >12 years) were screened from the period of January 2016 to June 2021 of which 144 cases showing findings of DM Nephropathy were included in the study. Medicolegal and paediatric autopsy cases were excluded from the study. Gross features of various organs were recorded. sections from kidneys were studied using Haematoxylin and eosin stain and other special stains wherever required. Diabetic nephropathy classification was done according to Histopathologic classification for DN which was established in 2010. Results and discussion- Out of total 144 cases of Diabetic Nephropathy, 61 (42.36%) cases belonged to class II, 74 (51.39%) cases belonged to class III and 9 (6.25%) cases belonged to class IV. Clinical history of Diabetic nephropathy was present in 113 (78.47%) cases while 31 (21.53%) cases showed features of Diabetic Nephropathy as an incidental finding at autopsy. Average age of these 144 patients was 56 years (range 22- 86 years). 86 were males, 58 were females with male to female ratio of 1.5:1. Conclusion- 144 cases of diabetic nephropathy included 61 cases (42.36%) of class II DN, 74 cases (51.39%) of class III DN and 9 cases (6.25%) of class IV DN. 31 cases (21.53%) showed features of diabetic nephropathy as an incidental finding at autopsy which were otherwise not diagnosed clinically during patients’ life. Autopsy provides a vital doorway to study, identify and detect clinically missed cases of diabetic nephropathy providing more accurate statistical data that can help to recognize the real burden of many such diseases which might get missed otherwise without help of autopsy.