dc.contributor | Vall d'Hebron Barcelona Hospital Campus |
dc.contributor.author | Rodríguez-Rodríguez, Rosa |
dc.contributor.author | Hojs, Radovan |
dc.contributor.author | Trevisani, Francesco |
dc.contributor.author | Morales, Enrique |
dc.contributor.author | Fernández-Juárez, Gema |
dc.contributor.author | Bevc, Sebastjan |
dc.contributor.author | Moreso Mateos, Francesc |
dc.contributor.author | García Carro, Clara |
dc.date.accessioned | 2022-04-25T10:27:11Z |
dc.date.available | 2022-04-25T10:27:11Z |
dc.date.issued | 2021-09 |
dc.identifier.citation | Rodríguez-Rodríguez R, Hojs R, Trevisani F, Morales E, Fernández G, Bevc S, et al. The Role of Vascular Lesions in Diabetes Across a Spectrum of Clinical Kidney Disease. Kidney Int Rep. 2021 Sep;6(9):2392–403. |
dc.identifier.issn | 2468-0249 |
dc.identifier.uri | https://hdl.handle.net/11351/7392 |
dc.description | Albuminuria; Diabetes; Histology |
dc.description.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. |
dc.language.iso | eng |
dc.publisher | Elsevier |
dc.relation.ispartofseries | Kidney International Reports;6(9) |
dc.rights | Attribution-NonCommercial-NoDerivatives 4.0 International |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ |
dc.source | Scientia |
dc.subject | Vasos sanguinis - Malalties - Complicacions |
dc.subject | Nefropaties diabètiques - Etiologia |
dc.subject.mesh | Diabetic Nephropathies |
dc.subject.mesh | /etiology |
dc.subject.mesh | Cardiovascular Diseases |
dc.subject.mesh | /complications |
dc.title | The Role of Vascular Lesions in Diabetes Across a Spectrum of Clinical Kidney Disease |
dc.type | info:eu-repo/semantics/article |
dc.identifier.doi | 10.1016/j.ekir.2021.06.001 |
dc.subject.decs | nefropatías diabéticas |
dc.subject.decs | /etiología |
dc.subject.decs | enfermedades cardiovasculares |
dc.subject.decs | /complicaciones |
dc.relation.publishversion | https://doi.org/10.1016/j.ekir.2021.06.001 |
dc.type.version | info:eu-repo/semantics/publishedVersion |
dc.audience | Professionals |
dc.contributor.organismes | Institut Català de la Salut |
dc.contributor.authoraffiliation | [Rodríguez-Rodríguez R] Hospital Universitario de Canarias, Pathology Department, Tenerife, Spain. University of La Laguna, Faculty of Medicine, Tenerife, Spain. [Hojs R, Bevc S] Department of Nephrology, Clinic for Internal Medicine, University Clinical Centre Maribor and Faculty of Medicine, University of Maribor, Slovenia. [Trevisani F] IRCCS Ospedale San Raffaele, URI–Urological Research Institute, Milano, Italy. [Morales E] Hospital 12 de Octubre, Madrid, Spain. [Fernández G] Hospital Universitario Fundación Alcorcón, Madrid, Spain. REDINREN ISCIII, Madrid, Spain. [Moreso F] REDINREN ISCIII, Madrid, Spain. Vall d'Hebron Hospital Universitari, Barcelona, Spain. [García Garro C] Vall d'Hebron Hospital Universitari, Barcelona, Spain |
dc.identifier.pmid | 34514200 |
dc.identifier.wos | 000696709200018 |
dc.relation.projectid | info:eu-repo/grantAgreement/ES/PE2013-2016/PI18%2F01386 |
dc.rights.accessrights | info:eu-repo/semantics/openAccess |