The Role of Vascular Lesions in Diabetes Across a Spectrum of Clinical Kidney Disease
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Standard
The Role of Vascular Lesions in Diabetes Across a Spectrum of Clinical Kidney Disease. / Rodríguez-Rodríguez, Rosa; Hojs, Radovan; Trevisani, Francesco; Morales, Enrique; Fernández, Gema; Bevc, Sebastjan; Cases Corona, Clara María; Cruzado, Josep María; Quero, María; Navarro Díaz, Maruja; Bettiga, Arianna; Di Marco, Federico; López Martínez, Marina; Moreso, Francisco; García Garro, Clara; Khazim, Khaled; Ghanem, Fedaa; Praga, Manuel; Ibernón, Meritxell; Laranjinha, Ivo; Mendonça, Luís; Bigotte Vieira, Miguel; Hornum, Mads; Feldt-Rasmussen, Bo; Fernández-Fernández, Beatriz; Concepción, Patricia Fox; Negrín Mena, Natalia; Ortiz, Alberto; Porrini, Esteban; DIABESITY working group of the ERA.
I: Kidney International Reports, Bind 6, Nr. 9, 2021, s. 2392-2403.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - The Role of Vascular Lesions in Diabetes Across a Spectrum of Clinical Kidney Disease
AU - Rodríguez-Rodríguez, Rosa
AU - Hojs, Radovan
AU - Trevisani, Francesco
AU - Morales, Enrique
AU - Fernández, Gema
AU - Bevc, Sebastjan
AU - Cases Corona, Clara María
AU - Cruzado, Josep María
AU - Quero, María
AU - Navarro Díaz, Maruja
AU - Bettiga, Arianna
AU - Di Marco, Federico
AU - López Martínez, Marina
AU - Moreso, Francisco
AU - García Garro, Clara
AU - Khazim, Khaled
AU - Ghanem, Fedaa
AU - Praga, Manuel
AU - Ibernón, Meritxell
AU - Laranjinha, Ivo
AU - Mendonça, Luís
AU - Bigotte Vieira, Miguel
AU - Hornum, Mads
AU - Feldt-Rasmussen, Bo
AU - Fernández-Fernández, Beatriz
AU - Concepción, Patricia Fox
AU - Negrín Mena, Natalia
AU - Ortiz, Alberto
AU - Porrini, Esteban
AU - DIABESITY working group of the ERA
N1 - Publisher Copyright: © 2021
PY - 2021
Y1 - 2021
N2 - Introduction: The clinical-histologic correlation in diabetic nephropathy is not completely known. Methods: We analyzed nephrectomy specimens from 90 patients with diabetes and diverse degrees of proteinuria and glomerular filtration rate (GFR). Results: Thirty-six (40%) subjects had normoalbuminuria, 33 (37%) microalbuminuria, and 21 (23%) non-nephrotic proteinuria. Mean estimated GFR (eGFR) was 65±23 (40% <60 ml/min per 1.73 m2). About 170 glomeruli per patient were analyzed, and all samples included vascular tissue. Six subjects (7%) were classified in diabetic nephropathy class I, 61 (68%) in class II-a, 13 (14%) in class II-b, 9 (10%) class III, and 1 (1%) in class IV. Eighty percent to 90% of those with normoalbuminuria or microalbuminuria were classified in class II-a or II-b and <10% in class III; 52% of those with proteinuria were in class II-a, 15% in class II-b, and 19% in class III. Nodular sclerosis (57%) and mesangial expansion (15%) were more frequent in cases with proteinuria than in normoalbuminuria (28% and 8%; P = 0.028 and 0.017). About 20% to 30% of all cases, regardless the level of albuminuria or proteinuria or the histologic class had tubular atrophy, interstitial fibrosis, or inflammation in >10% to 20% of the sample. Moderate hyalinosis and arteriolar sclerosis were observed in 80% to 100% of cases with normoalbuminuria, microalbuminuria, proteinuria, as well as in class I, II, or III. Conclusions: Weak correspondence between analytical parameters and kidney histology was found. Thus, disease may progress undetected from the early clinical stages of the disease. Finally, vascular damage was a very common finding, which highlights the role of ischemic intrarenal disease in diabetes.
AB - Introduction: The clinical-histologic correlation in diabetic nephropathy is not completely known. Methods: We analyzed nephrectomy specimens from 90 patients with diabetes and diverse degrees of proteinuria and glomerular filtration rate (GFR). Results: Thirty-six (40%) subjects had normoalbuminuria, 33 (37%) microalbuminuria, and 21 (23%) non-nephrotic proteinuria. Mean estimated GFR (eGFR) was 65±23 (40% <60 ml/min per 1.73 m2). About 170 glomeruli per patient were analyzed, and all samples included vascular tissue. Six subjects (7%) were classified in diabetic nephropathy class I, 61 (68%) in class II-a, 13 (14%) in class II-b, 9 (10%) class III, and 1 (1%) in class IV. Eighty percent to 90% of those with normoalbuminuria or microalbuminuria were classified in class II-a or II-b and <10% in class III; 52% of those with proteinuria were in class II-a, 15% in class II-b, and 19% in class III. Nodular sclerosis (57%) and mesangial expansion (15%) were more frequent in cases with proteinuria than in normoalbuminuria (28% and 8%; P = 0.028 and 0.017). About 20% to 30% of all cases, regardless the level of albuminuria or proteinuria or the histologic class had tubular atrophy, interstitial fibrosis, or inflammation in >10% to 20% of the sample. Moderate hyalinosis and arteriolar sclerosis were observed in 80% to 100% of cases with normoalbuminuria, microalbuminuria, proteinuria, as well as in class I, II, or III. Conclusions: Weak correspondence between analytical parameters and kidney histology was found. Thus, disease may progress undetected from the early clinical stages of the disease. Finally, vascular damage was a very common finding, which highlights the role of ischemic intrarenal disease in diabetes.
KW - albuminuria
KW - chronic kidney disease
KW - diabetes
KW - diabetic nephropathy
KW - histology
KW - normoalbuminuria
U2 - 10.1016/j.ekir.2021.06.001
DO - 10.1016/j.ekir.2021.06.001
M3 - Journal article
C2 - 34514200
AN - SCOPUS:85112215673
VL - 6
SP - 2392
EP - 2403
JO - Kidney International Reports
JF - Kidney International Reports
SN - 2468-0249
IS - 9
ER -
ID: 302195822