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Case Report
Primary nephrosclerosis in a type 1 diabetic patient
1 Section of Nephrology, Department of Internal Medicine, 3 Dipartimento di Scienze Cliniche e Biologiche, University of Turin and 2 SC DiabetologyASO S.Giovanni Battista, Turin, Italy
Correspondence and offprint requests to: Giorgina Barbara Piccoli, MD, Section of Nephrology of the University of Turin, Corso Bramante 8688, 10126 Torino, Italy. Email: gbpiccoli@yahoo.it or giorgina.piccoli@unito.it
Keywords: diabetes mellitus; kidneypancreas transplantation; nephrosclerosis; pre-emptive transplantation; renal biopsy
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| Introduction |
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End-stage renal disease is a well known long-term complication of type 1 diabetes. Its diagnosis in typical cases is obvious, and, in non-typical cases, i.e. those lacking the classic hallmark of proteinuria or showing discrepancies between end-organ damage (in particular between nephropathy and retinopathy), a renal biopsy is usually indicated [1]. However, the work-up protocol is tailored for patients referred early to nephrologists. The clinical choice may be less clear, however, in the case of late referral, when the renal disease is advanced and a renal biopsy (displaying the presence of a non-diabetic nephropathy) is probably of minor therapeutic relevance.
The present case report is that of a patient referred late to the nephrologist, who performed a renal biopsy because of an atypical course, during
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