10/10
Final thoughts:
✈️🚉🚗 we made it to #ERA26, sorry we're a little late on the posts! @nephroseeker.medsky.social
Renal biopsy in diabetics is still a gold standard to rule out NDKD and improve the survival in diabetic patients…
Up next, LBCT from #ERA26
Join us at nephjc.com
#TenPostNephJC
#NephSky #NephJC
1/10
How often do we miss non-diabetic kidney disease (NDKD)?
🚩NDKD are 1) active urine sediment, 2) sudden worsening RFT, 3) absence of retinopathy 4) systemic symptoms like rash
@glombandit.bsky.social
kidney-international.org/article/S008...
Nephrology Journal Club
Nephrology Journal Club
7/10
More questions ❓ #NephJC
🔬Should we routinely do biopsies in pts with diabetes & not assume DN?
🔬Is the risk of complications too high (bleeding/infection) to warrant?
🔬Based upon this study, in your opinion, will doing more biopsies change treatment strategies?
2/10
This retrospective study aims to:
🔬Robustly quantify the true frequency of NDKD
🔬Characterize biopsy diagnoses
🔬Identify the clinical and demographic factors associated with NDKD
6/10
Questions❓#NephJC
There is considerable heterogeneity in NDKD prevalence across studies; what could explain this?
9/10
I want more info.
Blog by
Dr. Priya John @dramiliflores.bsky.social
nephjc.com/news/2026/6/...
VA by @dramiliflores.bsky.social
nephjc.com/news/2026/6/...
8/10
Consensus:
The indications can guide you for the biopsy:
🔬Age <30 or >60
🔬Active urine sediment
🔬AKI/Acute Nephritic presentation/RPRF
🔬Atypical symptoms: arthritis / rash
🔬Better to avoid in DM pts with CKD & proteinuria without atypical features
5/10
A figure paints a thousand words 🎨🖌️
The indication for biopsy predicts likelihood of DN, NDKD and the co-existence of the two.
Nephrology Journal Club
4/10
1 post results:
Cohort 1-
Diabetic Nephropathy DN = 41.2%
DN & DKD = 22.9%
NDKD = 35.9%
Overall, 58.8% of NDKD in all biopsies
🤔perhaps biopsy is done when NDKD indications are present
Higher chronicity in biopsy—lower incidence of NDKD
3/10
1 post methods:
Retrospective 👀biopsies with DM, 2001- 24
1) Cohort 1 (49K): All included for NDKD frequency
2) Cohort 2 (14K): pts with biopsy-proven DN with clinical indication for the biopsy available
3) Subset (400): further analyzed for Cr, UPCR, in/outpt
