Pathogenesis of Kidney Disease in Type 1 Diabetes: a Modern Kidney Biopsy Cohort (The PANDA Study)

You may not qualify if:

• T2D and monogenic diabetes (rationale: our study focuses on T1D)
• Recent diabetic ketoacidosis, i.e., \<1 month (rationale: safety and insulin resistance and tubular dysfunction of DKA can confound study findings)
• eGFR \< 30 ml/min/1.73m2 or dialysis treatment (rationale: to reduce the likelihood of identifying secondary pathways that are not specific to kidney injury from T1D)
• Kidney transplant recipients (rationale: molecular confounding from immunosuppression)
• Kidney biopsy contraindications (rationale: safety - kidney biopsy):
• Evidence of bleeding disorder or complications from bleeding
• Use of aspirin, Nonsteroidal anti-inflammatory drugs (NSAIDS) or other blood thinner that cannot be safely stopped for a sufficient time before and after the biopsy to avoid additional risk of bleeding.
• INR \> 1.4
• Hemoglobin (Hgb) \< 10 mg/dL (Colorado) \[altitude\]
• Hemoglobin (Hgb) \< 9 mg/dL (Washington)
• Platelet count \< 100,000 / µL
• Uncontrolled or difficult to control hypertension (\> 150/90 mmHg at the day of biopsy)
• Single kidney (either by history, documented by prior imaging or ultrasound performed prior to the biopsy)
• Kidney size: One or both kidneys \< 8 cm
• Hydronephrosis or other important renal ultrasound findings such as significant stone disease
• +3 more criteria