Clinical and Pathological Spectrum of Diabetic Nephropathy in Type 2 Di-abetes Mellitus

Background: Diabetic nephropathy (DN) is a major complication of type 2 diabetes mellitus (T2DM) and aleading cause of end-stage renal disease. Differentiating DN from non-diabetic renal disease (NDRD) remains adiagnostic challenge, especially since clinical presentations often overlap.Aim: To evaluate ‘the histopathological spectrum of renal diseases in patients with T2DM undergoing biopsy andassess the association of DN with demographic features, comorbidities, and microalbuminuria.Methodology: This prospective study was conducted over three months at Netaji Subhas Medical College andHospital, Patna, India. A total of 80 adult T2DM patients undergoing renal biopsy were included. Specimens wereanalyzed using light microscopy, immunofluorescence, and electron microscopy. Patients were classified ashaving isolated DN, NDRD, or NDRD superimposed on DN. Statistical analysis was performed using SPSS v27.Results: Of the 80 patients, 35.5% had isolated DN, 14.5% had NDRD superimposed on DN, and 50% hadisolated NDRD. DN was more prevalent in males aged 41–50. Among DN patients, 90% had hypertension andobesity, and 80% had hypercholesterolemia. Microalbuminuria severity was notably higher in DN patients, with50% showing mild, 40% moderate, and 10% severe levels, while none had normoalbuminuria. In contrast, 48.57%of non-DN patients had normoalbuminuria.Conclusion: A significant proportion of T2DM patients exhibit renal pathology other than classic DN.Histological evaluation via biopsy remains essential for accurate diagnosis, guiding appropriate managementstrategies.