In late 2007 or early 2008 Andrew’s internal medicine specialist started noting some changes in his kidney values.

–Sorry, for those not medically inclined, by “kidney values” I mean “parameters in the blood that we use to monitor renal function”. Like “normal” or “normal range” (which means “the bell curve of individual metabolites measured in the blood that are considered normal in an adult”) “kidney values” is medical shorthand.–

Anyway, change in kidney values, right.
Because he is diabetic Andrew’s internist wanted to know why there were changes in Andrew’s kidney values. Those sorts of changes aren’t unusual to see in a diabetic patient, but Andrew was a little young for them to start showing up. So the internist, of course, was curious. Which meant biopsy.
*Ick*

–Another side note: Yes. I am a medical professional. I am, however, a medical professional for things that don’t tend to walk on two legs and stuff involving people and medical care tends to give me the squicks. The idea of having someone jam a needle into my kidney makes me weak in the knees. —

Renal biopsy.
Scheduled and done in June 2008.
Turns out that Andrew’s nephropathy isn’t really diabetic nephropathy it is a heritable immune mediated nephropathy that is complicated by diabetes. When we told Joan of the diagnosis she mentioned that her father had had some sort of chronic kidney issue, but kidney disease hadn’t been a contributor to his death.
The information is vague, but if I were to take a medical guess at it I’d suspect that whatever was going on with Grampy’s kidneys was probably similar to whatever has been going on with Andrew’s kidneys. It’s just that Andrew is concurrently diabetic which accelerated the renal disease process.

I don’t know why it’s so important to me to emphasize to everyone in sight that Andrew’s kidney disease didn’t start as diabetic nephropathy, but it is so there you go.