Arteriolar Hyalinosis Predicts the Onset of Both Macroalbuminuria and Impaired Renal Function in Patients with Type 2 Diabetes.
Nephron
; 148(6): 390-398, 2024.
Article
en En
| MEDLINE
| ID: mdl-38118427
ABSTRACT
INTRODUCTION:
Arteriolar hyalinosis (AH) has been shown to be associated with albuminuria and GFR. In this study, we investigated whether or not index of AH (IAH) is a predictor of the onset of macroalbuminuria and impaired renal function (eGFR <60 mL/min/1.73 m2 [eGFR <60]) in type 2 diabetic patients with early diabetic nephropathy.METHODS:
The study population consisted of 35 patients with type 2 diabetes (25 men; age 47 ± 9 years; eGFR 92.7 ± 18.0 mL/min/1.73 m2) with normo- or microalbuminuria who underwent percutaneous renal biopsy. These patients were followed for at least 5 (18 ± 6, range 6-28) years. The study endpoint was the onset of macroalbuminuria or eGFR <60. Light and electron microscopy-based morphometric analyses were performed to quantitatively evaluate glomerular and interstitial structural changes.RESULTS:
During the observation period, 9 out of the 35 patients progressed to macroalbuminuria, and 15 out of the 35 patients developed eGFR <60. The annual rate of eGFR decline was significantly correlated with IAH (r = -0.40, p = 0.016). Kaplan-Meier analysis demonstrated that AH was associated with a significantly higher risk of onset of macroalbuminuria and eGFR <60, and microalbuminuria is associated with the onset of macroalbuminuria but not the onset of eGFR <60.CONCLUSIONS:
Aggravated AH is a histological risk factor which predicts the onset of macroalbuminuria and eGFR <60 in patients with type 2 diabetes. These findings provide novel insights into the mechanism of progression of diabetic nephropathy.Palabras clave
Texto completo:
1
Colección:
01-internacional
Asunto principal:
Diabetes Mellitus Tipo 2
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Nefropatías Diabéticas
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Albuminuria
/
Tasa de Filtración Glomerular
Límite:
Adult
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Female
/
Humans
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Male
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Middle aged
Idioma:
En
Revista:
Nephron
Año:
2024
Tipo del documento:
Article