Non‐diabetic kidney disease in patients with diabetes undergoing native kidney biopsy

Diabetes is often assumed to cause chronic kidney disease (CKD) in patients with diabetes, though non-diabetic pathology may coexist. We reviewed 84 patients with diabetes who underwent native kidney biopsy (2017-2023). Indications included active urinary sediment, nephrotic-range proteinuria and rapid renal decline. Non-diabetic pathology was found in 49% and mixed lesions in 21%, mainly IgA nephropathy, acute tubular necrosis and interstitial nephritis. Biopsy altered management in 23% of cases. These findings support the value of biopsy in patients with diabetes.