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Title :Clinicopathological features of fast eGFR decliners among patients with diabetic nephropathy
Authors :Furuichi, Kengo
Shimizu, Miho
Yamanouchi, Masayuki
Hoshino, Junichi
Sakai, Norihiko
Iwata, Yasunori
Toyama, Tadashi
Kitajima, Shinji
Hara, Akinori
Yuzawa, Yukio
Kitamura, Hiroshi
Suzuki, Yoshiki
Sato, Hiroshi
Uesugi, Noriko
Ueda, Yoshihiko
Nishi, Shinichi
Nishino, Tomoya
Samejima, Kenichi
Kohagura, Kentaro
Shibagaki, Yugo
Makino, Hirofumi
Matsuo, Seiichi
Ubara, Yoshifumi
Yokoyama, Hitoshi
Wada, Takashi
Issue Date :4-Jun-2020
Abstract :Introduction The speed of declining kidney function differs among patients with diabetic nephropathy. This study was undertaken to clarify clinical and pathological features that affect the speed of declining kidney function in patients with diabetic nephropathy. Research design and methods This study was design as multicenter retrospective study. The subjects (377 patients with diabetic nephropathy diagnosed by kidney biopsy at 13 centers in Japan) were classified into three groups based on the estimated glomerular filtration rate (eGFR) declining speed. The eGFR increasing group, the control group, and the eGFR declining group were divided at 0 and 5 mL/min/1.73 m2/year, respectively. Characteristics of clinicopathological findings of declining kidney function were evaluated. Results The mean observation period of this study was 6.9 years. The control group, the eGFR increasing group, and the eGFR declining group included 81, 66, and 230 patients, respectively. The incidences of composite kidney events represented by 100 persons/year were 25.8 in the eGFR declining group and 2.0 in the eGFR increasing group. After adjustment for age, sex, systolic blood pressure, hemoglobin, and urinary albumin levels, three clinicopathological findings (urinary albumin levels, presence of nodular lesion, and mesangiolysis) were risk factors for inclusion in the eGFR declining group (the ORs were 1.49, 2.18, and 2.08, respectively). In contrast, the presence of subendothelial space widening and polar vasculosis were characteristic findings for inclusion in the eGFR increasing group (the ORs were 0.53 and 0.41, respectively). Conclusions As well as urinary albumin elevation, nodular lesion and mesangiolysis were characteristic pathological features of patients with fast declining kidney function.
URL :http://doi.org/10.1136/bmjdrc-2019-001157
Type Local :雑誌掲載論文
ISSN :2052-4897
Publisher :BMJ Publishing Group
URI :http://hdl.handle.net/20.500.12000/47090
Citation :BMJ Open Diabetes Research and Care Vol.8 no.1
Appears in Collections:Peer-reviewed Journal Articles (Faculty of Medicine)

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