Diabetic Nephropathy in People With Diabetes. Prevalence and Predictive Factors

Inclusion Criteria: * Age ≥ 18 years * Written informed consent * Diagnosis with T2DM according to the American diabetes Association (20) * eGFR \>30 mL/min/1.73 m2 (maximum six months old) * urine-albumin/creatinine-ratio (uACR) \> 700 mg/g or 24 hours urine albumin \>700 mg on more than one measurement Exclusion Criteria: * Signs of acute kidney failure according to the KDIGO classification (21) at the time for kidney biopsy or the last 6 months before kidney biopsy * Factors that increases the risk of complications due to kidney biopsy: * Hemoglobin \< 6 mmol/L * INR \>1,4 at the time for biopsy * Platelet count \< 100 x 109/l * Uncontrolled high blood pressure (defined as systolic blood pressure \> 160 mmHg and/or diastolic blood pressure \> 100 mmHg) * Only one functioning kidney * Evidence of urinary tract obstruction or hydronephrosis at the time of biopsy * Multiple bilateral kidney cysts * Kidney infection, peri-renal infection, or cutaneous infection that overlies the kidney at time for biopsy * Unwilling to receive blood transfusion * Unable to lie flat in bed six hours after biopsy * Any other contra-indications for percutaneous kidney biopsy according to local clinical guidelines * Unable to understand written and oral information * Kidney transplant recipient * Previous medical kidney biopsy * Women who are pregnant or planning to become pregnant before the kidney biopsy is performed * Treatment with Marcoumar (all other anticoagulants are accepted) * High thromboembolic risk combined with held in anticoagulation therapy according to the report "Perioperative regulation of antithrombotic treatment" (PRAB) (22) * mechanical heart valve * atrial fibrillation AND CHA2DS2-VASc\> 5 and/or stroke within the last three months * recurrent venous thromboembolism OR venous thromboembolism within the last three months * less than 6 weeks after uncomplicated Acute Coronary Syndrome (ACS) with or without revascularization (Percutaneous Coronary Intervention (PCI)) with Bare Metal Stents (BMS) or Coronary Artery Bypass Grafting (CABG)) * less than 3 months after uncomplicated ACS with revascularization (PCI with Drug Eluting Stent (DES)) * less than 9-12 months after complicated ACS (e.g. reinfarction or stent thrombosis) * less than 1 month after revascularization in individuals with stable Coronary Artery Disease (CAD) (PCI with BMS or CABG) * less than 3 months after revascularization in individuals with stable CAD (PCI with DES) * less than 3 months after stroke, or Transient Ischemic Attack (TIA) * Inability to withdraw nonsteroidal anti-inflammatory drugs (NSAID) 7 days before biopsy If a participant meets one or more exclusion criteria, that are reversible, the participant can be rescreened later on, to evaluate whether or not the participant now is qualified for participation.