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Polar vasculosis is associated with better kidney outcome in type 2 diabetes with biopsy‐proven diabetic kidney disease: A multicenter cohort study

AIMS/INTRODUCTION: This multicenter cohort study retrospectively assessed the association between polar vasculosis and the progression of diabetic kidney disease (DKD) in type 2 diabetes. MATERIALS AND METHODS: We enrolled 811 patients with type 2 diabetes, biopsy‐proven DKD, and proteinuria (≥0.15 ...

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Autores principales: Shimizu, Miho, Furuichi, Kengo, Toyama, Tadashi, Yamanouchi, Masayuki, Hoshino, Junichi, Kitajima, Shinji, Hara, Akinori, Iwata, Yasunori, Sakai, Norihiko, Yuzawa, Yukio, Kitamura, Hiroshi, Sato, Hiroshi, Shibagaki, Yugo, Suzuki, Yoshiki, Uesugi, Noriko, Ueda, Yoshihiko, Kohagura, Kentaro, Samejima, Kenichi, Tsuruya, Kazuhiko, Nishi, Shinichi, Nishino, Tomoya, Makino, Hirofumi, Matsuo, Seiichi, Ubara, Yoshifumi, Yokoyama, Hitoshi, Wada, Takashi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10583646/
https://www.ncbi.nlm.nih.gov/pubmed/37483063
http://dx.doi.org/10.1111/jdi.14059
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author Shimizu, Miho
Furuichi, Kengo
Toyama, Tadashi
Yamanouchi, Masayuki
Hoshino, Junichi
Kitajima, Shinji
Hara, Akinori
Iwata, Yasunori
Sakai, Norihiko
Yuzawa, Yukio
Kitamura, Hiroshi
Sato, Hiroshi
Shibagaki, Yugo
Suzuki, Yoshiki
Uesugi, Noriko
Ueda, Yoshihiko
Kohagura, Kentaro
Samejima, Kenichi
Tsuruya, Kazuhiko
Nishi, Shinichi
Nishino, Tomoya
Makino, Hirofumi
Matsuo, Seiichi
Ubara, Yoshifumi
Yokoyama, Hitoshi
Wada, Takashi
author_facet Shimizu, Miho
Furuichi, Kengo
Toyama, Tadashi
Yamanouchi, Masayuki
Hoshino, Junichi
Kitajima, Shinji
Hara, Akinori
Iwata, Yasunori
Sakai, Norihiko
Yuzawa, Yukio
Kitamura, Hiroshi
Sato, Hiroshi
Shibagaki, Yugo
Suzuki, Yoshiki
Uesugi, Noriko
Ueda, Yoshihiko
Kohagura, Kentaro
Samejima, Kenichi
Tsuruya, Kazuhiko
Nishi, Shinichi
Nishino, Tomoya
Makino, Hirofumi
Matsuo, Seiichi
Ubara, Yoshifumi
Yokoyama, Hitoshi
Wada, Takashi
author_sort Shimizu, Miho
collection PubMed
description AIMS/INTRODUCTION: This multicenter cohort study retrospectively assessed the association between polar vasculosis and the progression of diabetic kidney disease (DKD) in type 2 diabetes. MATERIALS AND METHODS: We enrolled 811 patients with type 2 diabetes, biopsy‐proven DKD, and proteinuria (≥0.15 g/g creatinine [g/day]). The association between polar vasculosis and other kidney lesions was explored. The outcome was DKD progression defined as a composite of renal replacement therapy initiation or 50% decline in estimated glomerular filtration rate (eGFR) from baseline. RESULTS: Of the 811 cases, 677 (83.5%) had polar vasculosis. In multivariate logistic regression analysis, subendothelial widening of the glomerular basement membrane, glomerulomegaly, glomerular class in the Renal Pathology Society classification ≥IIb, vascular lesions, age, eGFR, and hemoglobin A1c were positively associated with polar vasculosis, whereas interstitial fibrosis and tubular atrophy (IFTA) was negatively associated with polar vasculosis. During a median follow‐up of 5.2 years, progression of DKD occurred in 322 of 677 (7.4 events/100 person‐years) and 79 of 134 (11.4 events/100 person‐years) cases with and without polar vasculosis, respectively. Kaplan–Meier analysis showed that polar vasculosis was associated with lower cumulative incidences of DKD progression. Multivariate Cox regression analyses showed that polar vasculosis was associated with a lower risk of DKD progression, regardless of eGFR or proteinuria subgroups. These associations between polar vasculosis and better kidney outcome were unchanged considering all‐cause mortality before DKD progression as a competing event. CONCLUSIONS: This study showed that polar vasculosis of DKD was associated with less advanced IFTA and a better kidney outcome in type 2 diabetes with proteinuria.
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spelling pubmed-105836462023-10-19 Polar vasculosis is associated with better kidney outcome in type 2 diabetes with biopsy‐proven diabetic kidney disease: A multicenter cohort study Shimizu, Miho Furuichi, Kengo Toyama, Tadashi Yamanouchi, Masayuki Hoshino, Junichi Kitajima, Shinji Hara, Akinori Iwata, Yasunori Sakai, Norihiko Yuzawa, Yukio Kitamura, Hiroshi Sato, Hiroshi Shibagaki, Yugo Suzuki, Yoshiki Uesugi, Noriko Ueda, Yoshihiko Kohagura, Kentaro Samejima, Kenichi Tsuruya, Kazuhiko Nishi, Shinichi Nishino, Tomoya Makino, Hirofumi Matsuo, Seiichi Ubara, Yoshifumi Yokoyama, Hitoshi Wada, Takashi J Diabetes Investig Articles AIMS/INTRODUCTION: This multicenter cohort study retrospectively assessed the association between polar vasculosis and the progression of diabetic kidney disease (DKD) in type 2 diabetes. MATERIALS AND METHODS: We enrolled 811 patients with type 2 diabetes, biopsy‐proven DKD, and proteinuria (≥0.15 g/g creatinine [g/day]). The association between polar vasculosis and other kidney lesions was explored. The outcome was DKD progression defined as a composite of renal replacement therapy initiation or 50% decline in estimated glomerular filtration rate (eGFR) from baseline. RESULTS: Of the 811 cases, 677 (83.5%) had polar vasculosis. In multivariate logistic regression analysis, subendothelial widening of the glomerular basement membrane, glomerulomegaly, glomerular class in the Renal Pathology Society classification ≥IIb, vascular lesions, age, eGFR, and hemoglobin A1c were positively associated with polar vasculosis, whereas interstitial fibrosis and tubular atrophy (IFTA) was negatively associated with polar vasculosis. During a median follow‐up of 5.2 years, progression of DKD occurred in 322 of 677 (7.4 events/100 person‐years) and 79 of 134 (11.4 events/100 person‐years) cases with and without polar vasculosis, respectively. Kaplan–Meier analysis showed that polar vasculosis was associated with lower cumulative incidences of DKD progression. Multivariate Cox regression analyses showed that polar vasculosis was associated with a lower risk of DKD progression, regardless of eGFR or proteinuria subgroups. These associations between polar vasculosis and better kidney outcome were unchanged considering all‐cause mortality before DKD progression as a competing event. CONCLUSIONS: This study showed that polar vasculosis of DKD was associated with less advanced IFTA and a better kidney outcome in type 2 diabetes with proteinuria. John Wiley and Sons Inc. 2023-07-22 /pmc/articles/PMC10583646/ /pubmed/37483063 http://dx.doi.org/10.1111/jdi.14059 Text en © 2023 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Articles
Shimizu, Miho
Furuichi, Kengo
Toyama, Tadashi
Yamanouchi, Masayuki
Hoshino, Junichi
Kitajima, Shinji
Hara, Akinori
Iwata, Yasunori
Sakai, Norihiko
Yuzawa, Yukio
Kitamura, Hiroshi
Sato, Hiroshi
Shibagaki, Yugo
Suzuki, Yoshiki
Uesugi, Noriko
Ueda, Yoshihiko
Kohagura, Kentaro
Samejima, Kenichi
Tsuruya, Kazuhiko
Nishi, Shinichi
Nishino, Tomoya
Makino, Hirofumi
Matsuo, Seiichi
Ubara, Yoshifumi
Yokoyama, Hitoshi
Wada, Takashi
Polar vasculosis is associated with better kidney outcome in type 2 diabetes with biopsy‐proven diabetic kidney disease: A multicenter cohort study
title Polar vasculosis is associated with better kidney outcome in type 2 diabetes with biopsy‐proven diabetic kidney disease: A multicenter cohort study
title_full Polar vasculosis is associated with better kidney outcome in type 2 diabetes with biopsy‐proven diabetic kidney disease: A multicenter cohort study
title_fullStr Polar vasculosis is associated with better kidney outcome in type 2 diabetes with biopsy‐proven diabetic kidney disease: A multicenter cohort study
title_full_unstemmed Polar vasculosis is associated with better kidney outcome in type 2 diabetes with biopsy‐proven diabetic kidney disease: A multicenter cohort study
title_short Polar vasculosis is associated with better kidney outcome in type 2 diabetes with biopsy‐proven diabetic kidney disease: A multicenter cohort study
title_sort polar vasculosis is associated with better kidney outcome in type 2 diabetes with biopsy‐proven diabetic kidney disease: a multicenter cohort study
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10583646/
https://www.ncbi.nlm.nih.gov/pubmed/37483063
http://dx.doi.org/10.1111/jdi.14059
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