Clinicopathological features and outcomes of diabetic kidney disease with extracapillary hypercellularity: a Japanese single-center experience View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2020-02-10

AUTHORS

Ayano Saito, Atsushi Komatsuda, Masaya Saito, Hajime Kaga, Fumito Abe, Masato Sawamura, Mizuho Nara, Ryuta Sato, Hideki Wakui, Naoto Takahashi

ABSTRACT

BackgroundThe prognostic significance of glomerular extracapillary hypercellularity (EXHC) in diabetic kidney disease (DKD) is unclear. The aim of this study was to investigate the clinicopathological features and outcomes of DKD patients with EXHC.MethodsWe studied 70 cases of renal biopsy-confirmed type 2 DKD that were diagnosed between 2004 and 2014 and compared the clinicopathological features and outcomes of 22 patients with EXHC (EXHC group) with those of 48 patients without EXHC (control group). All of the patients were Japanese. We assessed the renal biopsy specimens based on the Renal Pathology Society classification system. Clinical and laboratory data were collected at the time of the renal biopsy, and renal outcomes were assessed based on progression to end-stage renal disease (ESRD) requiring renal replacement therapy. The median duration of the observation period was 3 years.ResultsIn pathological features, nodular sclerosis (Kimmelstiel–Wilson lesions) was observed more frequently in the EXHC group than in the control group (63.6% vs. 35.4%, P = 0.027). There were no significant intergroup differences in clinical features or renal outcomes. Univariate and multivariate Cox regression analyses of all patients showed that a high level of proteinuria, a low initial eGFR, and severe interstitial inflammation were poor prognostic factors.ConclusionsEXHC is related to nodular sclerosis, which is a known risk factor for ESRD. Careful observation is needed during the follow-up of DKD patients with EXHC, although there were no significant differences in renal outcomes between the EXHC and control groups. More... »

PAGES

509-517

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s10157-020-01859-y

DOI

http://dx.doi.org/10.1007/s10157-020-01859-y

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1124769082

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/32037471


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83 progression
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86 renal biopsy
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92 risk factors
93 sclerosis
94 severe interstitial inflammation
95 significance
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97 significant intergroup differences
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