N+NDGD / SCOREStudy & references

NEPHROLOGY · CLINICAL CALCULATOR

NDGD score

Assess non-diabetic glomerular disease in patients with T2DM and nephrotic-range proteinuria.

Research model

Developed and evaluated in 289 patients who underwent kidney biopsy. External validation is required before routine clinical use.

01

Clinical context

Type 2 diabetes with native kidneys (no kidney transplant)
Are any of the following features present?
  • Signs of systemic disease
  • Accelerated hypertension
  • A rapid decline in eGFR of >30% over weeks to months
Nephrotic-range proteinuria

Urine protein ≥3.5 g/day or UPCR ≥3 g/gCr, as defined in the study.

If any feature is present, consider a diagnostic work-up, including kidney biopsy, without calculating the NDGD score.

02

Score inputs

0 / 7
years

≥70 years → +4 points

years

≤5 years → +2.5 points

g/dL

≥12 g/dL → +1.5 points

mL/min/1.73 m²

45–<60 → +1.5 · ≥60 → +3
Use the 2021 CKD-EPI creatinine equation.

History of hypertension —

Before the onset of nephrotic-range proteinuria.

RAS blockade prescribed solely for its antiproteinuric effect does not count as a history of hypertension.

Diabetic retinopathy —

Based on an ophthalmologist’s assessment.

Urine sediment —

Glomerular hematuria contributes 6.5 points only. Do not add the additional hematuria point.

03

Score-based pathway

When none of the features above are present
SCORE <3

Follow-up

SCORE 3–6.5

Consider kidney biopsy

SCORE ≥7

Recommend kidney biopsy

Recommendations follow the supplied decision pathway and require clinical judgment. The score has not been externally validated.

STUDY REFERENCE

Clinical Predictors of Non-Diabetic Glomerular Disease in Type 2 Diabetic Patients With Nephrotic-Range Proteinuria

Sittipath Tirasattayapitak, Kanin Thammavaranucupt, Kavee Limbutara, Nitcha Suphatheerawatr, Wanjak Pongsittisak, Chutima Chavanisakun, Nontawat Benjakul, and Solos Jaturapisanukul.

Corresponding author: Solos Jaturapisanukul

Nephrology. 2026;31:e70275.

doi:10.1111/nep.70275 ↗

Retrospective single-center cohort · Vajira Hospital, Thailand · 2014–2022 · AUROC 0.85 (95% CI 0.80–0.89)