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ePublished: 27 Jan 2016
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J Renal Inj Prev. 2016;5(1): 45-47.
doi: 10.15171/jrip.2016.10
PMID: 27069968
PMCID: PMC4827386
  Abstract View: 3572
  PDF Download: 1783

Case Report

IgA-dominant post-infectious glomerulonephritis; making another case in support of renal biopsy in type 2 diabetic nephropathy

Ali Nayer 1, Gargi Davda 2, Rima Pai 2, Luis M. Ortega 2*

1 Division of Nephrology and Hypertension, University of Miami Miller School of Medicine, Miami, FL, USA
2 Division of Nephrology and Hypertension, Allegheny Health Network, Temple University School of Medicine, Pittsburgh, PA, USA
*Corresponding Author: *Corresponding author: Luis M. Ortega, , Email: lortega@wpahs.org

Abstract

Background: Approximately one-third of individuals with type 2 diabetes mellitus will eventually develop diabetic nephropathy (DN). Impaired renal function in type 2 diabetics may also be secondary to non-diabetic renal disease (NDRD). NDRD in type 2 diabetics may occur alone in the absence of DN or may be superimposed on DN. Renal biopsy maybe indicated to establish the correct diagnosis and to ascertain the severity of glomerular and tubulointerstitial pathology.

Case: We report a patient with type 2 diabetes mellitus and chronic renal insufficiency who developed worsening of renal function in the setting of staphylococcal infection and antibiotic use.

Conclusion: Renal biopsy revealed IgA-dominant post-infectious glomerulonephritis and acute interstitial nephritis superimposed on diabetic glomerulosclerosis. Accumulating evidence indicates that, NDRD accounts for impaired renal function in a significant number of patients with type 2 diabetes mellitus. The presence of clinical, biochemical, and radiological features that suggest NDRD should prompt pathological evaluation of the kidney.


Implication for health policy/practice/research/medical education:

Non-diabetic renal disease may account for impaired renal function in a significant proportion of patients with type 2 diabetes mellitus. Thus, renal biopsy maybe necessary to elucidate the exact cause of renal disease in patients with type 2 diabetes. Histopathological evaluation of the kidney provides an accurate diagnosis and will guide treatment.

Please cite this paper as: Nayer A, Davda G, Pai R, Ortega LM. IgA-dominant post-infectious glomerulonephritis; making another case in support of renal biopsy in type 2 diabetic nephropathy. J Renal Inj Prev. 2016;5(1):45-47. DOI: 10.15171/jrip.2016.1

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