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Title: The Role of Vascular Lesions in Diabetes Across a Spectrum of Clinical Kidney Disease
Author: Rodríguez Rodríguez, Rosa
Hojs, Radovan
Trevisani, Francesco
Morales, Enrique
Fernández, Gema
Bevc, Sebastjan
Cases Corona, Clara Maria
Cruzado, Josep Ma.
Quero, Maria
Navarro Díaz, Maruja
Bettiga, Arianna
Di Marco, Federico
López Martínez, Marina
Moreso, Francesc
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
Fox, Patricia Concepción
Negrín Mena, Natalia
Ortiz, Alberto
Porrini, Esteban
Director/Tutor: Proteïnúria
Keywords: Nefropaties diabètiques
Diabetic nephropathies
Issue Date: 1-Sep-2021
Publisher: Elsevier BV
Abstract: 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.
Note: Reproducció del document publicat a:
It is part of: Kidney International Reports, 2021, vol. 6, num. 9, p. 2392-2403
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ISSN: 2468-0249
Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

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