Non-Diabetic Kidney Disease in a Patient with Type 2 Diabetes Mellitus: A Diagnostic Challenge

Authors

• Nikhil R, JSS MEDICAL COLLEGE, JSS ACADEMY OF HIGHER EDUCATION AND RESEARCH, MYSURUFollow
• MAHABALESHWAR MAMADAPUR , Assistant Professor, Department of Clinical Immunology and Rheumatology, JSS Medical College and Hsopital, JSS Academy of Higher Education and ReseachFollow
• HARSHWARDHAN S PATIL, Department of Pharmacy Practice JSS College of Pharmacy, MysuruFollow

Author ORCID Identifier

0009-0001-5227-0569

0000-0001-7421-2418

0009-0009-2000-7924

Corresponding Author

Nikhil R Senior Resident, Dept. of Clinical Immunology and Rheumatology, JSS Medical College, JSS Academy of Higher Research, Mysuru  E- Mail ID: [email protected]

Orcid ID : 0009-0001-5227-0569

Abstract

Background: Diabetic kidney disease (DKD) is the most common cause of end-stage renal disease. However, non-diabetic kidney disease (NDKD) can coexist or mimic DKD, leading to misdiagnosis. Case Presentation: A 46-year-old female with type 2 diabetes presented with vomiting and abdominal pain. Physical examination revealed non-blanching erythematous papules on both lower limbs. Investigations showed uncontrolled diabetes, metabolic acidosis, and active urinary sediment. Absence of diabetic retinopathy prompted renal biopsy, which revealed immune-complex–mediated glomerulonephritis with small-vessel vasculitis. Diagnosis: Immune-complex–mediated glomerulonephritis with small-vessel vasculitis, not consistent with diabetic nephropathy. Management: Supportive care and immunosuppressive therapy were initiated with improvement in renal function. Conclusion: This case emphasizes the importance of renal biopsy in diabetic patients with atypical renal findings to differentiate NDKD from DKD.

Publication Date

Spring 4-5-2026

Publisher

JSS Academy of Higher Education & Research

Conflict of Interest

None

Keywords

Diabetic kidney disease, Non-diabetic kidney disease, Renal biopsy, Immune-complex glomerulonephritis, Small-vessel vasculitis, Type 2 diabetes, Diabetic nephropathy mimic.

Word Count

946

Recommended Citation

R N, MAMADAPUR M , Assistant Professor, PATIL H. Non-Diabetic Kidney Disease in a Patient with Type 2 Diabetes Mellitus: A Diagnostic Challenge. Digital Journal of Clinical Medicine. 2026; 8(2): -. doi: https://doi.org/10.55691/2582-3868.1319

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.